Intramedullary Pin (IM Pin) Specification, Uses, Sizes and Surgical Techniques.

Intramedullary Pins IM Pins

Intramedullary Pin (IM Pin) is a thin metal rod commonly used in orthopedic procedures for holding large bone fractures together. These pins function similarly to K Wire, but are larger in diameter.

Intramedullary Pins are available in various Types, lengths and diameters.
Types: Single Trocar, Double Trocar, Single Trocar Threaded, Trocar & Threaded, Centre Threaded
Diameters: 1mm, 2mm, 2.5mm, 3mm, 3.5mm, 4mm, 4.5mm, 5mm, 5.5mm, 6mm, 6.5mm, 7mm and 8 mm
Lengths: 100 mm to 250 mm

Intramedullary Pin (IM Pin) Specification

Intramedullary Pin (IM Pin) insertion remains the most commonly performed procedure in orthopaedic practice. Although its use for definitive fracture treatment has steadily declined due to advent of newer implants and devices, it still finds application in treatment in fractures suffered by medically unfit and paediatric patients and for providing interim traction in almost all lower limb injuries as well as hip and knee pathologies.

Upper tibial Steinman pin insertion is required for most fractures around the hip joint and the femur. The insertion of a Steinman pin is a relatively safe procedure if the basic principles of insertion are adhered to. Complications like infection and pin loosening are quite common especially if the pins are retained for longer duration, which is rarely the scenario these days. Besides other complications like damage to ligaments & growth plate, pin cut through, major complications do occur like deep peroneal nerve palsy leading to foot drop, growth plate damage in children and pseudoaneurysm of anterior tibial artery.

Intramedullary Pin (IM Pin) Indications for Use

Intramedullary Pins (IM Pins) are indicated for use in the fixation of bone fractures, bone reconstruction, and as guide pins for insertion of other implant. The size of the Pin chosen should be adapted to the specific indication. Surgeon judgement is required to ensure a Intramedullary Pin (IM Pin) is appropriate for the indication. There is a potential risk of Intramedullary Pin (IM Pin) migration in some fracture fixation applications such as the clavicle.

Intramedullary Pins (IM Pins) are indicated for use only in the following conditions:

Bone trauma requiring internal fixation for healing.
Fixation of soft tissue to bone where Pins are able to so do safely.
Bone lengthening and shortening procedures.
Osteotomies and other realignment procedures.

Intramedullary Pin (IM Pin) Contraindications

Contraindications may be qualified or total, and need to be taken into consideration when evaluating the prognosis in each case. Alternative management techniques may need to be considered under the following conditions:

Acute or chronic infections, either local or systemic.
Local or systemic accurate or chronic inflammation.
Serve muscular, nervous or vascular disease endangering the affected area.
Defective bone structures, which would impede adequate anchoring of the implant.
All associated diseases which could endanger the function and success of the implant.

Warnings and Precautionary for Intramedullary Pin (IM Pin)

Before using Intramedullary Pin (IM Pin), the surgeon and ancillary staff should study the safety information in these instructions, as well as any product-specific information in the product description, surgical procedures and/or brochures.

Intramedullary Pins (IM Pins) are made from surgical grade 316L Stainless Steel and are designed, constructed and produced with utmost care. These quality Intramedullary Pins (IM Pins) assure best working results provided they are used in the proper manner. Therefore, the following instructions for use and safety recommendations must be observed.

Improper use of this instrument can lead to damage to the tissue, premature wear, destruction of the instruments and injury to the operator, patients or other persons.

It is vital for the operating surgeon to take an active role in the medical management of their patients. The surgeon should thoroughly understand all aspects of the surgical procedure and instruments including their limitations. Care in appropriate selection and proper use of surgical instruments is the responsibility of the surgeon and the surgical team. Adequate surgical training should be completed before use of Intramedullary Pins (IM Pins).

Factors which could impair the success of the operation:

Allergies to implanted materials.
Localized bone tumours.
Osteoporosis or osteomalacia.
System disease and metabolic disturbances.
Alcohol and drug abuse.
Physical activities involving excessive shocks, whereby the implant is exposed to blows and/or excessive loading.
Patients who are mentally unable to understand and comply with the doctor’s instructions.
Poor general health.

Possible Adverse Effects

The following adverse effects are the most common resulting from implantation:

Loosening of the implant, which may result from cyclic loading of the fixation site and/or tissue reaction of the implant.
Early and late infection.
Further bone fracture resulting from unusual stress or weakened bone substance.
Temporary or chronic neural damage resulting from pressure or hematomata.
Wound hematomas and delayed wound healing.
Vascular disease including venal thrombosis, pulmonary embolism and cardiac arrest.
Heterotopic ossification.
Pain and discomfort due to presence of the implant.
Mechanical failure of the implant, including bending, loosening or breakage.
Migration of implant resulting in injury.

Preoperative Planning for Intramedullary Pin (IM Pin)

The operating planning is carried out following a thorough clinical evaluation of the patient, Also, x-rays must be taken to allow a clear indication of the bony anatomy and associated deformities. At the time of the operation, the corresponding implantation instruments in addition to a complete set of implants must be available.

The clinician should discuss with the patient the possible risks and complications associated with the use of Intramedullary Pins (IM Pins). It is important to determine pre-operatively whether the patient is allergic to any of the implant materials. Also, the patient needs to be informed that the performance of the device cannot be guaranteed as complications can affect the life expectancy of the device.

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