Fixation

The screw configuration should always be determined based on the fracture type and bone quality. The NCB System technology allows polyaxial screw placement in a 30° cone. Screw locking is achieved through the use of locking caps that are threaded into the holes in the plate.
In this case example the femur was not exposed in the diaphyseal area and  all screws in the diaphyseal region were inserted percutaneously. Distal screws have been inserted first and the proximal screws could be placed bicortical anterior or posterior to the prosthesis.

Surgeons Tip
In order to go around the stem of the prosthesis and achieve bicortical fixation it may be necessary to drill completely into cortical bone. Inserting screws into the outer edge of the cortical bone may lead to cortical fractures. The use of taps may mitigate these cortical fractures.