the present invention relates to alignment systems and methods for detecting a distal hole of an intramedullary nail . a jig is attached to the proximal end of the nail and also mounted on the bone . the jig has an adjustable positioning head that includes a drill axis hole along with an alignment pin . the alignment pin includes reference marks that are visible in x - ray images and helps to align the positioning head drill axis with the distal hole of the intramedullary nail . a light source is insertable into the nail in order to shine light out of the distal hole to illuminate a spot on the bone surface as an alignment aid . viewing optics are mountable on the positioning head for viewing the illuminated spot created by the light source in the intramedullary nail .