Weils osteotomy-screw driver in use
Image of screw driver in use

It is useful to excert a degree of control/counter pressure when the screw is being inserted by placing a thumb firmly underneath the metatarsal head whilst downward pressure is applied with the twist -off screw.

During insertion the metatarsal head may become distracted rather than compressed. This is usually corrects once the screw is fully driven home. This on occasion will require further manual insertion of the screw using screw driver, whilst applying counter -pressure under the metatarsal head.