Technical Article: Short-segment Placement of Proximal Tibial Half-pins

Proximal tibial fixation of hexapod frame rings can be challenging due to a balance between concerns about the available space to provide adequate ring stability against the desire for proximal placement of corticotomies to aid regenerate formation. The aim of this study was to describe and analyse our technique for short-segment, three half-pin placement.

We describe a novel method of orientation and placement of half-pins to enable repeatable placement of three 6 mm pins within only 18 mm of tibia. Patients who received this configuration of half-pins over a 12-month period were identified from our institution database and analysed for complications defined as peri-implant fractures, clinically detected pin site loosening, septic arthritis, or revision surgery due to proximal pin sites.

We identified 26 patients who received this configuration of proximal half-pins, average age of 45 (range 24-80) with no complications reported as per our definition.

This configuration of proximal half-pins provides excellent fixation in the minimum amount of bone possible, providing sufficient proximal tibial space for high corticotomies.Level of evidence: III - Retrospective case series.

Fletcher JW, Mitchell SR. Technical Article: Short-segment Placement of Proximal Tibial Half-pins. Strategies Trauma Limb Reconstr 2024;19(3):161-163.