- in most cases, antegrade screw insertion across the fracture site, will result in fracture site compression;
- once the medial threads have passed the fracture site, fracture compression usually takes place;
- remove one of the two hexagonal nuts, and then advance the remaining screw up to the fracture site, in order to apply compression;
- once adequate compression is achieved, consider applying a second hexagonal nut in order to prevent migration of the compression nut
Original Text by Clifford R. Wheeless, III, MD.