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Calcaneal traction pin placement simplified: a cadaveric study.

John Y Kwon¹, J Kent Ellington, Daniel Marsland

¹Harvard Medical School, Department of Orthopaedic Surgery, Massachusetts Beneral Hospital, Boston, MA, USA. johnkwonmd@gmail.com

Foot & Ankle International

|July 8, 2011

Summary

A 3.1 cm safe zone around the posterior inferior calcaneus is identified for transcalcaneal pin placement. This technique minimizes risks to the tibial neurovascular bundle and sural nerve during surgery.

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Area of Science:

Orthopedic surgery
Anatomy
Surgical safety

Background:

Transcalcaneal pin placement risks injury to the tibial neurovascular bundle and sural nerve.
Establishing a safe zone is crucial, especially in trauma cases.
Anatomical variations necessitate precise surgical guidance.

Purpose of the Study:

Determine a relative safe zone for transcalcaneal pin placement.
Utilize a single osseous landmark for technique applicability.
Provide a reliable and safe surgical technique.

Main Methods:

Dissection of 24 cadavers to identify medial neurovascular structures and the sural nerve.
Measurement of the closest distance from neurovascular structures to the posterior inferior calcaneus.

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Calculation of a safe zone based on 95% confidence intervals.

Main Results:

The mean distance to the closest medial neurovascular structure was 3.4 cm.
The mean distance to the sural nerve was 3.4 cm.
A relative safe zone of 3.1 cm radius from the posterior inferior calcaneus was determined.

Conclusions:

A 3.1 cm radius from the posterior inferior calcaneus offers a safe zone for pin placement.
This technique reduces the risk of neurovascular injury during transcalcaneal procedures.
Anatomic variations require surgeon awareness, but the described technique enhances safety.