Cannulated screws Overview of surgical technique 1 Indication For fixation in osteotomies, arthrodeses and fractures of small and large bones. 6 Determine the screw length The gauge is pushed over the guide wire until it touches the cortex. The screw length shown includes the screw head. To avoid penetration of the countercortical bone, the next smaller screw length should be selected. This surgical technique is for general handling of the cannulated screw. Use without drill guide system 3 Reposition After repositioning of the fracture, it is temporarily fixed with a Kirschner wire. 7 Insertion of the screw The screw is inserted with the cannulated screwdriver with holding sleeve over the guide wire. Determine the optimal entry point for the intramedullary guide wire, make a stab incision and insert the guide wire to the required depth using the image converter. 5 Reaming the cortex The screws are usually self-drilling and self-tapping. However, if the cortical bone is particularly hard, we recommend drilling it out over the guide wire using a cannulated drill bit. If necessary, the bone must be reamed over the entire threadless length of the guide wire. 8 Position control Before removing the guide wire, a check is made in both planes. Unscrewing the guide wire. In thin cortical bone or osteoporotic bone, however, the head space should not be reamed and an additional washer should be used to prevent the cortical bone from splitting and the screw from sinking in. Hard cortex with countersunk screw head Thin cortex with washer Page 1 from 2 This surgical technique is based on the author's many years of experience as a surgeon. Its content has been carefully considered and verified by the author. However, it cannot take into account all the specifics of the individual case and is therefore only a suggestion. All information in this surgical technique is therefore provided without any guarantee on the part of the author. No liability is assumed by the author for damages of any kind. INTERCUS GmbH Tel.: +49 36741 588-0 | E-Mail: [email protected] | GERMANY INTERCUS Vertriebs GmbH Rudolstädter Straße 15 | 07422 Bad Blankenburg Tel.: +49 36741 586265 | E-Mail: [email protected] Tip! In very hard cortical bone, to avoid soft tissue reactions, a recess for the screw head can be milled into the bone with a cannulated headspace reamer.

Cannulated screws Overview of surgical technique Use with drill guide system 1 Reposition After repositioning of the fracture, it is temporarily fixed with a Kirschner wire. 4 Determine the screw length The gauge is pushed through the tissue protection sleeve (last sleeve) over the guide wire until it touches the cortex. The screw length shown includes the screw head. To avoid penetration of the countercortical bone, the next smaller screw length should be selected. 2 Entry point Determine the optimal entry point for the intramedullary guide wire. After stab incision, advance the drill guide...