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Related Experiment Videos

Percutaneous Kirschner wire fixation through the snuff box: an anatomic study

B D Steinberg1, K D Plancher, R S Idler

  • 1Indiana University School of Medicine, Indiana Hand Center, Indianapolis, USA.

The Journal of Hand Surgery
|January 1, 1995
PubMed
Summary

This study defines a safe zone in the anatomic snuff box for wrist procedures, minimizing risks to nerves and vessels. Findings aid surgeons in safely placing instruments like Kirschner wires and arthroscopes.

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Area of Science:

  • Orthopedics
  • Anatomy
  • Surgical Procedures

Background:

  • The radial wrist aspect and anatomic snuff box are critical for surgical access.
  • Precise anatomical knowledge is essential for safe instrument placement.

Purpose of the Study:

  • To define the safe zone for percutaneous instrument placement in the anatomic snuff box.
  • To identify risks associated with instrument placement outside this zone.
  • To establish optimal portals for wrist arthroscopy.

Main Methods:

  • Twenty fresh frozen cadaver upper extremities were used.
  • Three Kirschner wires were placed percutaneously under fluoroscopic guidance.
  • Anatomical dissection identified critical structures and measured the safe zone.

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Main Results:

  • A mean safe zone of 0.68 sq cm was identified deep to subcutaneous tissue.
  • The safe zone is bordered by the radial styloid, first dorsal compartment, radial artery, and superficial radial nerve.
  • Instruments placed outside this zone risked neurovascular injury.

Conclusions:

  • A defined safe zone in the anatomic snuff box enhances safety for Kirschner wire, screw, and arthroscope placement.
  • Limited incisions within the safe zone with blunt dissection minimize adjacent structure injury.
  • A new arthroscopic portal (1,2) was established within the snuff box based on improved anatomical understanding.