longitudinal bore 35 the plunger 30 may be directed into and through chamber 27 by the application of an external force at the handle 33 continuing with the description of dart fixation tool 25 illustrated in fig8 a drive rod 37 is carried by housing 31 and extends through central bore 38 of distal plug 36 drive rod 37 is threaded into a cartridge 26 such that rotation of drive rod 37 will rotate cartridge 26 with respect to housing 31 as can be seen in fig8 drive rod 37 is driven at its proximate end by a gear train comprised of bevel gear 39 which is engaged by gear 40 where gear 40 in turn is carried by housing 31 and connected to knurled knob 41 for rotation therewith thus the surgeon by rotating knurled knob 41 positions cartridge 26 relative to the housing 31 to align a chamber 27 with the longitudinal bore 35 of distal plug 36 to mechanically achieve this alignment the cartridge 26 carries a pair of balls 45 which are biased into engagement with distal plug 36 by springs 46 distal plug 36 contains a series of detents 47 which are located radially about the central axis of distal plug 36 and spaced equally such that chamber 27 alignment with longitudinal bore 35 occurs when balls 45 are biased into the detents 47 this permits the surgeon to index carridge 26.