SAFE LOCALIZATION FOR PLACEMENT OF PERCUTANEOUS PINS IN THE CALCANEUS

Area of Science:

• Orthopedic Surgery
• Anatomy
• Biomechanics

Background:

• Calcaneus fractures are common, and surgical repair often involves Kirschner wire fixation.
• Accurate anatomical knowledge is crucial to minimize iatrogenic injury during surgical procedures.

Purpose of the Study:

• To identify specific zones of risk within the calcaneus for surgical intervention.
• To quantify the potential for injury to key anatomical structures (artery, vein, nerve, tendon) during calcaneus procedures.

Main Methods:

• Utilized 53 cadaveric calcanei, systematically divided into zones and areas.
• Assessed injury risk to anatomical structures using the Licht classification system for Kirschner wire placement.
• Applied probability laws to quantify cumulative injury risk from multiple wire placements.

Main Results:

• Zone IA demonstrated the highest risk of artery or vein injury (43%).
• The risk of nerve injury was 13%, while tendon injury risk was 0% in the assessed zones.
• Risk stratification varied significantly across different calcaneus zones and anatomical structures.

Conclusions:

• The study successfully identified vulnerable anatomical structures within the calcaneus.
• Quantified injury risks associated with Kirschner wire placement, providing valuable data for surgical planning.