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Safe extracapsular placement of proximal tibia transfixation pins
T A DeCoster1, M K Crawford, M A Kraut
1Department of Orthopedics and Rehabilitation, University of New Mexico, Albuquerque, USA.
Journal of Orthopaedic Trauma
|May 26, 1999
Summary
Transfixation pins in the proximal tibia can avoid knee joint capsule penetration. Proper placement, more than 14mm from the subchondral line, ensures safety. Anterior placement requires at least 6mm clearance.
Area of Science:
- Orthopedic surgery
- Anatomy
Background:
- Accurate knowledge of the knee joint capsule's tibial insertion is crucial for orthopedic procedures.
- Transfixation pins and half-pins are commonly used in proximal tibia fracture fixation.
Purpose of the Study:
- To precisely define the capsular insertion site on the proximal tibia.
- To provide anatomical guidance for safe placement of transfixation pins.
Main Methods:
- Anatomical dissection of cadaveric knee specimens.
- Radiographic and arthroscopic evaluation of patient knees.
Main Results:
- The knee joint capsule inserts 4-14mm below the tibial articular surface.
- The anterior capsule is closer to the joint line (within 6mm).
- Posteromedial and posterolateral capsule extensions reach 14mm distally.
Conclusions:
- Transfixation pins can be safely placed >14mm from the subchondral bone.
- For anterior placements (<6mm), Zone 1 offers a safe corridor.
- Avoiding capsular penetration is key for successful tibial fixation.