exerted, to avoid sudden uncontrolled penetration of the inner plate, in view of the proximity of adjacent vital structures. The tubular soft tissue retractor or drill sleeve must be held securely against the bone by the assistant while the drill is withdrawn. The Mould pin is then inserted into the turnkey and the tip engaged in the drill hole. It may be necessary to search for this if the soft tissue has moved slightly, and the operator should be able to discern when the point catches the rim of the hole. The original 70째 angulation must be maintained and two or three revolutions of the hand-operated turnkey will usually convince the operator as to whether the pin is correctly orientated. The pin is screwed in until it is tight, but caution should be exercised when the ramus is thin and atrophic to avoid over penetration. In locating the position for the second pin, the operator must assess the soft tissue edema and the need to prevent the points of the pin shafts must not be too far apart, but sufficiently so to accommodate a universal joint on each shaft with
a further one placed between them. The hole is drilled in
converging direction to the first pin and the pin is inserted. Pairs of holes are then drilled in the distal fragment. The fractures may be oblique, with a surrounding haematoma which could become infected, so it is essential to make a careful assessment from the radiographs and to place the nearest pin at least 2-3 cm away from the fracture line. With multiple