Four years ago, I fell and broke my elbow. It was a real mess. The bones were way out of position. The surgery involved insertion of pins so the doctor must have used a surgical bone drill and pins to get it supported as well as possible.
After the cast came off, the elbow bone stuck out and it hurts whenever I put a lot of pressure on it or use the full range of motion.
I'm sure the surgeon used the equipment available and his bone working skills to the best of his ability, to repair the damage. Mending the body doesn't always bring the body part back to where it was.