Sign IM Nail and Interlocking Screw System Technique Manual page 37

Reaming
Be sure the fracture site is not distracted during
reaming, figure 4.
Nail insertion
The diameter of the nail is 1mm less than the
largest reamer that achieved chatter. Be sure
the fracture site is not distracted during
placement of the nail. Rotate the nail so the
distal interlocking screws will not be in the
vicinity of the radial nerve. The nail should be
flush with the entrance hole. Place bone wax
over the end of the nail after the L-handle is removed.
Interlocking
Interlocking is done as described in the technique used in all approaches. The difference in the
proximal interlock is that the screw must not penetrate the joint space. Make the pilot hole and
enlarge using the step drill. Use the back end of the depth gauge and push this in until it reaches the
subchondral bone. Turn the depth gauge around for measurement of the length of the screw.
Apply counter pressure
to the olecranon during
insertion of nail into distal
fragment.
37
Fig. 4