The chessboard technique - a new freehand aiming method for rapid distal locking of tibial nails.

Distal locking is considered a difficult stage of the endomedullary tibial nailing procedure. A new rapid, simple, and inexpensive freehand aiming technique is presented that uses a galvanized metal grid. The grid is positioned to overlay the skin of the medial cutaneous face of the tibia, giving to the underlying bone under fluoroscopy a pattern that resembles a chessboard. The squares of the grid permit a rapid and accurate localization of the corresponding distal holes of the endomedullary nail, requiring only a single fluoroscopy image, which can be important relative to radiation exposure.