Appendix 1: Method for the Definition of “Reference Positions” for the Insertion of Transosseous Elements

Abstract

“Reference positions” for the insertion of transosseous elements must comply with two most important requirements: minimum displacement of soft tissues during movement in the joints adjacent to the segment, and no risk of damage to great vessels and nerves. The use of positions with minimum displacement of soft tissues decreases the risk not only of pin-induced joint stiffness,but also of pin-tract infection because chronic traumatic injury to the soft tissues by the transosseous elements is reduced. When the displacement of soft tissues is not considered, the term “safe positions” is used.