The modular external fixator is optimal for temporary use. It is rapidly applied without need for intraoperative x-rays and can be adjusted later.
The biggest risk of temporary spanning external fixation of the proximal forearm is iatrogenic neurovascular nerve injury.
Knowing the safe zones and blunt dissection to bone is critical.
For safe pin placement make use of the
and be familiar with the anatomy of the humerus and the forearm.
Soft tissue dissection
Blunt dissection of the soft tissues and the use of small Langenbeck retractors will prevent damage to muscular, vascular and neurological structures.
Prepare a channel for insertion of the pin, using a blunt clamp down to the bone. If there is any doubt an incision should be made big enough to prove that the drill sleeve (mandatory for the humerus) will have direct contact with the bone.