For many years, external fixation pin use centered around the Kirschner-Ehmer (KE) external fixation device and newer modifications of it. This resulted in potentially confusing pin terminology that is poorly suited to the use of improved external fixation devices such as the IMEX® SK® external fixator. Modern, accurate terminology will clear up potential ordering errors and provide educators with a consistent vocabulary to train students, residents and practitioners. These changes will greatly simplify future pin discussion as well.
Using the medium KE clamp and a 3.2mm (1/8”) smooth pin as a common example, note that the term “medium” continues to be used for smooth pins, negative-profile pins and positive-profile pins, regardless of the fact that each creates a significantly different size and shape of pin tract in the patient’s bone. Since veterinarians were forced into using Kirschner terminology, a 3.2mm shaft positive-profile pin continued to be called a 3.2mm (1/8”) pin even though the thread diameter engaging the bone is actually 4.0mm.
Bone screw diameters are defined by the thread diameter of the screw regardless of the screw head diameter and it is logical to use the same terminology with external fixation pins. In other words, the portion of the implant that limits diameter choice is the portion that is implanted into bone, not the portion outside of the bone.
An example of a customer order using historic terminology for a positive-profile ESF pin might be:
“I want to order a 3.2mm (1/8”) Interface® pin” or “I used a 3.2mm (1/8”), medium, positive-profile pin.” This pin has a 3.2mm (1/8”) shaft and 4.0mm thread diameter. The word “medium” is often associated with either description.
An example of a representative customer order or inquiry for a 3.2mm (1/8”) Interface® positive-profile, medium pin, based on modern terminology would be:
“I want to order a 3.2/4.0mm Interface® pin” or “I used a 3.2/4.0mm positive-profile pin.” The term medium could be included with either description but is not necessary as mentioning both the shaft and thread diameters eliminates any potential for error while accurately providing both the shaft diameter, and more importantly, the thread diameter.
A likely ordering conversation using proper modern terminology for a “medium” Duraface® pin might be:
“I want a 4.0mm Duraface® pin” or “I need a medium, 4.0mm Duraface® pin.” Since the shaft and thread diameters of Duraface® pins are the same, it is not necessary to discuss the pin as a 4.0/4.0mm Duraface® pin.