Edited by Aron Lechtig, Grace Xiong - 4/11/23
Indications/Contraindications
Indications:
Femur: Vertical shear pelvic fractures, unstable hip fracture dislocations Tibial: Femoral shaft fractures with significant shortening
Materials/positioning
Materials:
- Marker
- Lidocaine (any percent or with or without epinephrine)
- 10 vs 20 cc syringe
- 2x 18G needles
- Chloraprep
- Stack of blankets (to elevate leg)
- Marking pen
- Sterile blue towels or half sheets to mark out sterile field
- Sterile gloves (2-3 pairs)
- Knife (11 blade preferred)
- Kelly clamp
- Drill with the chuck attachment (usually is a CD-4 drill with battery)
- Smooth Schanz pin
- Traction Bow
- Traction frame
- Rope (at least 4 feet)
- Weights (at least 15 pounds)
- Have portable Xray at the bedside and have lead available for you
- Xeroform
- Kerlix
Positioning:
Supine with a pillow or blanket under the leg to elevate above the contralateral leg.
Consider moving the patient to a hospital bed with the traction setup before pin placement.
Technique
Prior to Beginning Procedure
Obtain full length femur or tibial radiographs to ensure no underlying injury or lesion where pin will be placed.
Draw up 10 cc of local anesthetic to have ready.
Mark area:
Mark the borders of the patella, tibial tubercle, and medial and joint line.
Mark your intended start site:
Two finger breadths above the superior pole of the patella for a femoral pin, from medial to lateral.
Two finger breadths below the tibial tubercle and two finger breadths lateral for a tibial pin, from lateral to medial.
Preparation:
Pearls & Pitfalls
Potential complications:
Tips for efficiency: