Using the Universal Large Distractor For Tibial Nailing
Inserting the Schanz Screws
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· Proximal Schanz Screw

Make a small stab incision medially, 1 cm inferior and parallel to the tibial plateau. Use the Oscillating Attachment and the 3.5 mm Three-Fluted Drill Bit to drill through both cortices, from the posterior medial corner of the tibia and aiming for the fibular head. This position for the Schanz screw allows for reaming of the medullary canal without interference.

Use the Universal Chuck with T-Handle to insert a 5.0 mm Schanz Screw medial-to-laterally. In some cases, a 6.0 mm Schanz Screw may be needed to withstand the distraction forces.

· Distal Schanz Screw

Make a small stab incision in the medial aspect of the distal fragment, 0.5 cm to 1.0 cm above the tibial plafond.

Using the Oscillating Attachment and the 3.5 mm Three-Fluted Drill Bit, drill through both cortices. The drilled hole should be parallel to the joint surface, distal to the physeal scar and proximal to the medial malleolus. The Oscillating Attachment prevents spooling of the soft tissues and eliminates the need for a drill sleeve.

Using the Universal Chuck with T-Handle, insert a 5.0 mm Schanz Screw medial-to-laterally, parallel to the proximal screw.

Note: The Depth Gauge for Large External Fixator [393.78] may be used to measure the drilled hole and preset the Schanz screw in the chuck for the correct insertion depth.

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