Volume 1, 2015
|Number of page(s)||7|
|Published online||29 May 2015|
Avoidance of external fixation pin induced rotational stiffness in the forearm; a cadaver study of soft tissue displacement relative to the varying position of radius and ulna fixation
Vreden Russian Research Institute of Traumatology and Orthopedics, 8 Baykova Str., St. Petersburg
2 Dawson Creek and District Hospital, 11100-13th Street, Dawson Creek, BC V1G 3W8, Canada
3 St. Petersburg State University, Universitetskaya 7-9, St. Petersburg 199034, Russia
* Corresponding author: email@example.com
Accepted: 11 April 2015
Introduction: Stiffness of forearm rotation secondary to transfixion pin sites is a frequent complication of external fixation. Conventional surgical atlases do not consider the effect of rotation on skin displacement and thus do not provide a comprehensive answer. We asked: (1) in what locations in the forearm is soft tissue displacement relative to the ulna and radius least during rotation; (2) in what positions are major neurovascular structures absent; and (3) what maximal range of rotation can be expected in forearm external fixation.
Methods: Thirty-four matched cadaver arms were used to assess displacement of soft tissues at 10°, 30° and 70° of pronation and supination in relation to a testing frame. The results of these were correlated with positions in which neurovascular structures were absent and deemed insertional “Reference Positions (RP)”.
Results: Expected range of rotation in diaphyseal fractures of different levels of both forearm bones was found with RP for the ulna occurring along the length of the forearm. Reference positions for the radius which provide full forearm rotation are situated only in the distal third; positions which provide partial rotation are located in the proximal and middle third.
Discussion: Full range of rotation may be maintained in the case of isolated external fixation of ulnar diaphyseal fractures. In isolated external fixation of the radius a reduced range of forearm rotation may be expected.
Key words: Rotation stiffness / Forearm rotation / Transfixion pin-induced stiffness / Transosseus osteosynthesis / External fixation
© The Authors, published by EDP Sciences, 2015
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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