At the entry point, a stab incision is made through the skin with a pointed scalpel.
A Steinmann, or preferably a Denham pin, mounted in the T-handle, is inserted manually at a point about 2 cm dorsal to the tibial tuberosity.
As the pin is felt to penetrate the far cortex, check that the exit will coincide with the area of local anaesthetic infiltration. If not, inject additional local anaesthetic. Once the point of the pin clearly declares its exit site, make a small stab incision in the overlying skin.
Once the pin is in place, ensure that there is no tension on the skin at the entry and exit points. If there is, then a small relieving incision may be necessary.