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European Journal of Orthopaedic Surgery & Traumatology

Published in:

01-10-2020 | Original Article

Achievable pin spanning angulation in anterosuperior pelvic external fixation

Authors: Benjamin Young, Drayton Daily, Clarence Kee, Kevin Perry, Massimo Max Morandi, R. Shane Barton, Giovanni F. Solitro

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 7/2020

Abstract

Introduction

Pelvic external fixation using anterosuperior pins provides a quick method of stabilization without necessitating fluoroscopic guidance. Various locations, depths, and inclinations have been cited for external fixator pins; however, the existing literature lacks clear indications for the angular difference between pins. Thus, we aimed to determine the greatest degree of sagittal pin spanning angulation (SPSA) between two iliac crest pins and how intraosseous depth (ID) affects these angulations.

Materials and methods

A newly developed computer algorithm produced cross sections of 3D pelvic reconstructions in the sagittal plane in 5° increments. Computer-generated pins with IDs of 60, 75, and 90 mm were positioned in 5° increments transversely. Pins were assessed for cortical containment to define values for SPSA and transverse pin spanning angulation (TPSA).

Results

A bimodal distribution revealed varying degrees of insertion frequency and SPSA, cranially and caudally. The caudal distribution exhibited greater cortical containment with larger values for SPSA and TPSA. The highest insertion frequency (85.7%) and largest SPSA (155°) were observed for the 60-mm ID. Increasing ID resulted in further bony penetration and smaller values for SPSA and TPSA.

Conclusions

Expanding the degree of SPSA between inserted pins in anterosuperior pelvic external fixation can be challenging due to the thinning of the iliac wing, which affords a narrow corridor for intraosseous pin containment. An ID of 60 mm allows larger degrees of SPSA while maintaining higher rates of cortical pin containment when compared to pins with greater IDs.

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Title: Achievable pin spanning angulation in anterosuperior pelvic external fixation
Authors: Benjamin Young
Drayton Daily
Clarence Kee
Kevin Perry
Massimo Max Morandi
R. Shane Barton
Giovanni F. Solitro
Publication date: 01-10-2020
Publisher: Springer Paris
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 7/2020
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-020-02684-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Achievable pin spanning angulation in anterosuperior pelvic external fixation

Abstract

Introduction

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

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