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4Pin insertion (wrist)

Complications with pin insertion

The following three potential complications are of concern when inserting threaded pins for external fixation:

  • Injury to extensor tendons
  • Injury to the superficial branch of the radial nerve
  • Metacarpal fracture

The following precautions minimize the risk of these complications:

  • Knowledge of the anatomy and specific landmarks for pin insertion
  • Larger surgical incisions (1 cm over the second metacarpal, longer incision over the radius), instead of stab incisions
  • Blunt dissection to the bone
  • Predrilling prior to insertion of the pins