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

Affordable Access

Download Read

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

Authors
  • Kulesh, Pavel Nikolaevich
  • Fletcher, Matt D.A.
  • Solomin, Leonid N.
Type
Published Article
Journal
SICOT-J
Publisher
EDP Sciences
Publication Date
May 29, 2015
Volume
1
Identifiers
DOI: 10.1051/sicotj/2015005
Source
EDP Sciences
Keywords
Disciplines
  • Original Article
License
Green

Abstract

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.

Report this publication

Statistics

Seen <100 times
Downloaded <100 times