It is possible to drill 10° off center of each hole. Under fluoroscopy the radiolucent implant affords complete visualization to assure ideal screw placement. Drill, measure and insert screws, but do not completely tighten screws until all have been inserted. Alternately tighten screws opposite each other until all screw heads are brought flush with, but not below, the surface of the implant.
Obtain final fluoroscopic images in multiple planes to confirm bone alignment and screw placement. The wound is closed in layers. Patients are placed in a cast for 6-8 weeks.