Use of the external fixation apparatus for percutaneous insertion of pins in the distal one-third of the radius: an anatomic study.
OBJECTIVE
To assess the risk of soft-tissue injury during percutaneous placement of external fixation pins in the proximal radius.


DESIGN
An anatomic study with embalmed cadaver limbs.


SETTING
Hand and upper limb centre at a university-affiliated hospital.


INTERVENTIONS
Two 4-mm Hoffman half pins were percutaneously placed along the dorsoradial ridge of the radius, four finger breadths proximal to the radial styloid process.


MAIN OUTCOME MEASURES
Injuries to soft tissues including tendons, nerves and vessels were noted.


RESULTS
Nerve or tendon injuries occurred in 7 of 26 forearms. Three pins transfixed either the superficial branch of the radial nerve or lateral antebrachial cutaneous nerves. Tendon injuries included the brachioradialis in two forearms, the extensor carpi radialis brevis in three forearms, and the extensor carpi radialis longus and the abductor pollicis longus in one forearm each.


CONCLUSIONS
Percutaneous pin placement in the distal radius is unsafe. The authors recommend open pin placement for fractures of the distal radius.