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Related Experiment Video

Updated: Mar 22, 2026

Proximal Cadaveric Femur Preparation for Fracture Strength Testing and Quantitative CT-based Finite Element Analysis
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Reference positions for transosseous elements in femur: A cadaveric study.

Leonid N Solomin1, Maksim V Andrianov2, Munetomo Takata3

  • 1Vreden Russian Research Institute of Traumatology and Orthopedics, St. Petersburg, Russia.

Injury
|April 11, 2016
PubMed
Summary

This study identified optimal pin sites on the femur to minimize soft tissue displacement during external fixation. These findings help prevent infection and contracture, improving patient outcomes in orthopedic surgery.

Keywords:
Cadaver studyContractureExternal fixationPin site infectionSoft tissue displacement

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Area of Science:

  • Orthopedic Surgery
  • Biomechanical Engineering
  • Anatomy

Background:

  • External fixator pin sites are prone to soft tissue displacement, potentially causing infection and contracture.
  • The femur, with its thick soft tissues, is particularly susceptible to these complications.
  • Current anatomical guidance focuses on avoiding neurovascular bundles, not on minimizing soft tissue displacement at pin sites.

Purpose of the Study:

  • To identify specific pin insertion sites on the femur that exhibit minimal soft tissue displacement.
  • To provide data-driven reference positions for transosseous elements in external fixator applications.
  • To enhance safety and reduce complications associated with femoral external fixation.

Main Methods:

  • Divided the femoral shaft into eight levels and each cross-section into 12 radial positions.
  • Utilized 15 adult cadavers, inserting 12 wires radially at each level.
  • Measured soft tissue displacement (skin, fascia, muscle) across three joint motions (hip flexion/abduction, knee flexion).

Main Results:

  • Identified 89 directions with average soft tissue displacement across three joint motions.
  • Observed greater displacement in juxta-articular areas compared to the mid-diaphyseal region.
  • Displacement patterns varied by location, with higher values near joints and in specific directions (e.g., 6 o'clock near the hip, 12 o'clock near the knee).

Conclusions:

  • Defined 30 reference positions with minimal soft tissue displacement, avoiding major neurovascular bundles.
  • Recommended anterolateral sites near the hip and posterolateral sites near the knee.
  • These findings offer practical guidance for perioperative planning in femoral external fixation.