13
Apply External Compression
Instruments Used:
1. 8 mm Guide Sleeve (x 2) (9)
2. 4 mm Drill Guide (x 2) (8)
3. Trocar Obturator (6)
4. 4 mm Drill (23)
Thread the Trocar into the 8 mm Guide Sleeve. Insert the 8 mm Guide Sleeve and Trocar assembly into the more
distal tibial interlocking screw hole on the medial side of the Targeting Frame (passing through the Outer Tube Brace).
Make an incision at the Trocar tip and advance the Trocar down to bone. Leaving the Guide Sleeve in the Targeting
Frame, replace the Trocar with the 4 mm Drill Guide in the Guide Sleeve.
TECH TIPS
• The 4 mm Drill Guide should be placed just off the bone to ensure
that the targeting frame is floating freely during drilling.
• Do NOT place the second 4 mm Drill Guide on lateral side of frame (next step)
until AFTER advancing the Drill through the nail. The fibula can interact with
the lateral Drill Guide, which can push the Targeting Frame out of alignment.
• If not using a trauma triangle, make sure the targeting tubes are not resting
on any table or pillows. If using bumps or towels, move them to underneath ankle.
Drilling from the medial side, pass a fresh 4 mm Drill through the tibia and across the Targeting Frame. Thread
another 4 mm Drill Guide into a second 8 mm Guide Sleeve and insert the Guide assembly into the distal hole on
the lateral side of the Targeting Frame so that it abuts against the bone. Continue to insert the 4 mm Drill into the
Drill Guide on the lateral side (A). Leave the drill in place and rotate the Manual Compression Knob clockwise to
apply compression across the joint (B). The approximate amount of applied external compression can be determined
by reading the lasermarks on the Targeting Frame (C). Leave the Drill in place while proceeding to Step 14.
NOTE: If external compression is not desired, proceed to the
Quick Compress Technique on page 35 for tibial screw placement.
B
C
A
29