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What is the correct drilling and pin-placement procedure?

Sequence — one site at a time. Drill a site, push in its pin, then move to the next. Best practice is to alternate from the far right (or left) across to the far opposite site. It's critical not to move the Fixation Base with the pin. Stop the pin at the Fixation Base sleeve.

Malleting — "always mallet" is a good rule, even if only for the last few millimeters. Pins should have resistance so they don't loosen during the procedure.

If a pin goes in too easily / a pin is loose: Don't drill the next site to depth. Stop the drill 3–4 mm (or more) short of the stop and mallet the pin in until it's flush with the Fixation Base sleeve. If the base is still loose after all pins are seated, the bone is likely very low density. Wedge a cotton plug between bone and base to force the metal away from the bone and mimic the GSI report image. Be very careful assembling and disassembling the guides.

Tip: Always have back-up pin and drill kits on hand. Long drills are 25 mm; short drills are 21 mm. Pins are placed with a calibrated 2.0 mm drill matched to pin length. 

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