Standard Ilizarov technique uses the tensioned olive wires to provide interfragmentary compression in the acute fracture setting and in non-union surgery. In osteopenic metaphyseal bone this can lead to the olive “cutting through” the thin attenuated cortex reducing compression and stability.

We describe a technique placing a percutaneous 3 hole Synthes Mini-fragment plate against the outer cortex of the bone fragment. An olive wire is then placed through each of the outer two holes and through the bone fragment. The construct is then tensioned. This stops the olive cutting into the bone and allows increased compression which is particularly important in non-union surgery.