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4Pin insertion (wrist)

Landmarks for pin insertion in the radial shaft

The proximal two pins should be inserted proximal to the muscle bellies of abductor pollicis longus (APL) and extensor pollicis brevis (EPB), and should not penetrate them.

These muscles are usually easy to identify. Proximal to these muscles, the radial shaft can be palpated through the skin between the bellies of the extensor digitorum communis (EDC) and extensor carpi radialis longus/brevis (ECRL/ ECRB) over 3-4 cm. This is the preferred area for proximal pin insertion in the radial shaft.