Practical steps for Freehand Technique insertion of locking screws in intramedullary nails

Freehand Technique for drilling and insertion of locking screws in intramedullary nails can be technically demanding and prone to handling issues. It requires the precise placement of a screw through the holes in the nail under fluoroscopic guidance and can result in a time consuming procedure associated with exposure to radiation. Dedicated training as a result of experience can help overcome these problems. The Freehand Technique of interlocking screw placement is the current standard teaching in most orthopedic residency programs in United States.