A, AO technique for internal fixation of medial malleolus. Hole (3.2 mm) is drilled while distal fragment is held reduced with two Kirschner wires bent to stay out of way. Length of hole is measured. B, Insertion of malleolar screw without tapping. Kirschner wires are removed after screw is tightened. If fragment tends to rotate, additional smaller screw or compression wiring can be added. SEE TECHNIQUE 54.2.