USE OF THE EXTERNAL FIXATION APPARATUS FOR PERCUTANEOUS INSERTION OF PINS IN THE DISTAL 1 3 OF THE RADIUS - AN ANATOMIC STUDY/

Objective. To assess the risk of soft-tissue injury during percutaneou s 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 styl oid process. Main Outcome Measures: Injuries to soft tissues including tendons, nerves and vessels were noted. Results: Nerve or tendon inju ries occurred in 7 of 26 forearms. Three pins transfixed either the su perficial 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 extenso r carpi radialis longus and the abductor pollicis longus in one forear m each. Conclusions: Percutaneous pin placement in the distal radius i s unsafe. The authors recommend open pin placement for fractures of th e distal radius.