Fatih Barça MD, Ekin Barış Demir MD, Mustafa Fatih Sarı MD, Mutlu Akdoğan MD, Yalım Ateş MD, Halis Atıl Atilla MD
{"title":"Evaluating the role of fluoroscopy in calcaneal pin placement","authors":"Fatih Barça MD, Ekin Barış Demir MD, Mustafa Fatih Sarı MD, Mutlu Akdoğan MD, Yalım Ateş MD, Halis Atıl Atilla MD","doi":"10.1053/j.jfas.2025.03.017","DOIUrl":null,"url":null,"abstract":"<div><div><span>Although fluoroscopy-assisted calcaneal pin placement for ankle-spanning external fixation<span><span><span> or skeletal traction was advocated in the literature, evidence for necessity of </span>fluoroscopy<span> for this application is lacking. This study aimed to compare the calcaneal pin locations and complications of patients who underwent pin placement with and without fluoroscopy guidance. In this retrospective cohort study, adult patients that underwent external fixation for </span></span>ankle fractures<span><span> between October 2022 and May 2024 were included. The primary outcome was the rate of the pins that were inside the safe zone. Secondary outcomes were the distance of pins to the tip of medial malleolus and the posteriormost point of </span>calcaneus<span> and complications such as neurovascular deficit and calcaneal fracture. Eighty-two patients (mean age 47±16.4 - min. 18 - max. 89, 54.9 % male) were involved in the study. Forty-five patients (group 1) had their pins placed without fluoroscopy assistance and thirty-seven patients (group 2) with fluoroscopy assistance. Five patients (11.1 %) in group 1 and seven patients (18.9 %) in group 2 had their pins placed outside the safe zone (</span></span></span></span><em>P =</em> 0.320). Distance of the hole from medial malleolus was mean 38.8 ± 7.9 mm for group 1 and 51.3 ± 8.32 mm for group 2 (<em>P</em> < 0.001), and distance from posteriormost point of calcaneus was mean 25.2 ± 6.3 mm for group 1 and 21.4 ± 7.9 mm for group 2 (<em>P</em> = 0.019). No neurovascular complications or calcaneal fracture were seen during follow-up. In conclusion, fluoroscopy guidance does not provide any additional benefit for placing calcaneal pins.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 570-573"},"PeriodicalIF":1.3000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Foot & Ankle Surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1067251625000948","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Although fluoroscopy-assisted calcaneal pin placement for ankle-spanning external fixation or skeletal traction was advocated in the literature, evidence for necessity of fluoroscopy for this application is lacking. This study aimed to compare the calcaneal pin locations and complications of patients who underwent pin placement with and without fluoroscopy guidance. In this retrospective cohort study, adult patients that underwent external fixation for ankle fractures between October 2022 and May 2024 were included. The primary outcome was the rate of the pins that were inside the safe zone. Secondary outcomes were the distance of pins to the tip of medial malleolus and the posteriormost point of calcaneus and complications such as neurovascular deficit and calcaneal fracture. Eighty-two patients (mean age 47±16.4 - min. 18 - max. 89, 54.9 % male) were involved in the study. Forty-five patients (group 1) had their pins placed without fluoroscopy assistance and thirty-seven patients (group 2) with fluoroscopy assistance. Five patients (11.1 %) in group 1 and seven patients (18.9 %) in group 2 had their pins placed outside the safe zone (P = 0.320). Distance of the hole from medial malleolus was mean 38.8 ± 7.9 mm for group 1 and 51.3 ± 8.32 mm for group 2 (P < 0.001), and distance from posteriormost point of calcaneus was mean 25.2 ± 6.3 mm for group 1 and 21.4 ± 7.9 mm for group 2 (P = 0.019). No neurovascular complications or calcaneal fracture were seen during follow-up. In conclusion, fluoroscopy guidance does not provide any additional benefit for placing calcaneal pins.
期刊介绍:
The Journal of Foot & Ankle Surgery is the leading source for original, clinically-focused articles on the surgical and medical management of the foot and ankle. Each bi-monthly, peer-reviewed issue addresses relevant topics to the profession, such as: adult reconstruction of the forefoot; adult reconstruction of the hindfoot and ankle; diabetes; medicine/rheumatology; pediatrics; research; sports medicine; trauma; and tumors.