External fixator pin placement in the forearm: how safe is it? An anatomical study

An anatomical study was undertaken using cadaveric forearms to identify the best technique and angle of pin placement for external fixator pins. We have found that inserting pins through stab incisions risks transfixion of the underlying structures and leads to an increased morbidity. We conclude that inserting pins under direct vision is much safer and that the optimum angle of pin insertion is in the coronal plane, parallel to the plane of the metacarpals.