Percutaneous pinning is a technique used by orthopedic surgeons for the stabilisation of unstable fractures.
Many fractures can be manipulated into wholly satisfactory positions, immobilized in an appropriate cast and allowed to heal. Some fractures, however, cannot be held in a satisfactory position by this method, and require some additional form of fixation. This is the usual situation with all displaced fractures of the first metacarpal and of the proximal phalanges of the hand, and of about two thirds of fractures of the distal end of the radius.
Pinning involves the manipulation, with X-ray guidance, of the fracture into an acceptable position, and the immediate insertion of metal pins, called Kirschner wires, through the skin, into one bone fragment and across the fracture line into the other bone fragment. These pins are normally left in position for some four to six weeks, and are removed when the fracture has healed.
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