Distal Locking

Distal Locking Combination Options

  Click on image for enlarged view
nail insertion entry point Several distal locking technique options are available to the surgeon. The Radiolucent Drive provides a convenient technique for targeting and drilling the distal locking holes. The Radiolucent Drive reduces the working distance from the incision, offers less restricted positioning when using the image intensifier, and reduces operative time.

Alternatively, the locking technique with the Distal Aiming Device requires a minimum working distance of 47 cm between the receiver and the patient's leg; see page 37. If less working distance is available, see the alternative drilling technique in the Drilling in Two Steps section of this guide. As a farther option, the 4.0 mm/4.5 mm Drill Bit [355.90] may be used to drill for distal locking in the standard freehand fashion. The distal holes are locked first to maintain limb length and control rotation of the distal fragment.

The Universal Tibial Nail has three distal locking holes. Two holes are oriented mediolaterally (M-L), and one hole is oriented anteroposteriorly (A-P). Usually, locking is accomplished with two bolts, inserted medial to lateral. The chart below offers other locking options for special circumstances.

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