A novel coplanar X-ray guided method and device for insertion of distal
locking screws in intramedullary bone nails. The device has coplanar
holes, which allow insertion of protective sleeves. A drill and bone
screws can be inserted through the protective sleeves. Radiopaque target
markers in the aiming arm enable the easy positioning of an X-ray source
such that an X-ray beam is coplanar with the aiming arm transverse holes.
After the X-ray source is accurately oriented, a single X-ray snapshot is
enough to assess the exact distortion of the implanted intramedullary
nail. The X-ray beam need not be coaxial with the intramedullary nail
holes. The aiming arm has a mobile portion and a fixed portion fastened
to the nail, wherein said aiming arm can be adjusted, displacing the
mobile portion over the fixed portion, to compensate for the distortion
of the intramedullary nail after implantation. Once the aiming arm is
precisely positioned, the aiming arm transverse holes and intramedullary
nail holes are accurately aligned, protective sleeves are inserted
through aiming arm holes, bone drills are drilled through the
intramedullary nail holes and surrounding bone material, and bone screws
are inserted, locking the intramedullary nail to the bone.