CT Analysis of a Potential Safe Zone for Placing External Fixator Pins in the Humerus

Ye, Juncai; Li, Qiao; Chen, Zhineng; Zhao, Heng; Huang, Jie‐Feng; Nie, Jing

doi:10.1080/08941939.2019.1638471

Cited by 2 publications

(3 citation statements)

References 20 publications

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“…Several studies have been conducted in the hopes of defining a “safe zone” for distal pin insertion for external fixation of the upper arm [ 12 – 14 ]. However, most of these contained small study populations or were cadaveric studies done on adult populations [ 12 – 15 ] (Table 1 ), hindering the applicability of the results for use in younger patients. Additionally, results are usually given as an absolute distance from the elbow joint.…”

Section: Discussionmentioning

confidence: 99%

“…Many attempts have been made to determine a safe margin for distal humeral pin insertion, most of which were experiments on cadavers. These studies were performed on adult upper extremities and the results were presented as absolute values [ 12 – 16 ] (Table 1 ). These results are beneficial for determining the safe margin in adults; however, they are not applicable for patients with short humeri.…”

Section: Introductionmentioning

confidence: 99%

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Anatomic consideration of the radial nerve in relation to humeral length for unilateral external fixation: a retrospective study using magnetic resonance imaging findings in korean

Min

Ryu

Sung

et al. 2023

BMC Musculoskelet Disord

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Background This study aimed to present a safe zone for distal pin insertion for external fixation using magnetic resonance imaging (MRI) images. Methods All patients who took at least one upper arm MRI from June 2003 to July 2021 were searched via a clinical data warehouse. For measuring the humerus length, proximal and distal landmarks were set as the highest protruding point of the humeral head and lowermost margin of ossified bone of the lateral condyle, respectively. For children or adolescents with incomplete ossification, the uppermost and lowermost ossified margin of the ossification centers were set as proximal and distal landmarks respectively. The anterior exit point (AEP) was defined as the location of the radial nerve exiting the lateral intermuscular septum to the anterior humerus and distance between the distal margin of the humerus and AEP was measured. The proportions between the AEP and full humeral length were calculated. Results A total of 132 patients were enrolled for final analysis. The mean humerus length was 29.4 cm (range 12.9–34.6 cm). The mean distance between the ossified lateral condyle and AEP was 6.6 cm (range 3.0–10.6 cm). The mean ratio of the anterior exit point and humeral length was 22.5% (range 15.1–30.8%). The minimum ratio was 15.1%. Conclusion A percutaneous distal pin insertion for humeral lengthening with an external fixator may be safely done within 15% length of the distal humerus. If pin insertion is required more proximal than distal 15% of the humeral shaft, an open procedure or preoperative radiographic assessment is advised to prevent iatrogenic radial nerve injury.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Anatomic consideration of the radial nerve in relation to humeral length for unilateral external fixation: a retrospective study using magnetic resonance imaging findings in korean

Min

Ryu

Sung

et al. 2023

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…. This cadaveric CTbased investigation reports on the placement location and angle of external fixator pins in an effort to minimize this injury risk [5]. There have been other anatomic studies of the radial nerve, but these largely focus on the location of the nerve laterally, and not in a more three-dimensional manner [6,7].…”

mentioning

confidence: 99%