Technique Review - A Simple Distal Interlocking Aid for Intramedullary Nails

A Steinmann pin is pushed through the spout of a 50 ml bladder syringe as shown (Figure 1). With the plunger withdrawn the syringe can be used as a radiolucent handle to hold the Steinmann pin against the bone through a nick in the skin. The image intensifier is centered on the screw hole so that it appears as a perfect circle. Initially the tip of the Steinmann pin is placed with some angulation in the centre of the hole. With a few seconds of continuous screening it is possible to angulate the pin to the correct trajectory for the nail hole so that it appears as a dot within the nail hole (Figure 2). This confirms that the entry point and orientation of the pin are correct. With some hammering the position of the pin is secured and this acts as a punch to guide the drill.