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Schanz Pin Specification, Uses, Sizes and Surgical Techniques.

Schanz Pin

Schanz Pin is a metallic rod with pointed threads at one end and other end fashioned to fix into an attachment device.

Schanz Pins are available in various Types, lengths and diameters.
Types: Self Tapping, Self Drilling, Tapered Threaded
Diameters: 4mm, 4.5mm, 5mm, 5.5mm, 6mm, 6.5mm
Lengths: 60 mm to 300 mm

Schanz Pin Self Drilling has been specifically designed to optimise the bone/pin interface to reduce the occurrence of pin-tract related complications in external fixation.

The unique design of Schanz Pin Self Drilling reduces heat generation and insertion torque while improving pullout resistance in cortical and cancellous bone

Schanz Pin Self Tapping / Self Drilling Sizes

Dia x Thread Length x Total Length = 4 x 20 x 80 mm
Dia x Thread Length x Total Length = 4 x 30 x 100 mm
Dia x Thread Length x Total Length = 4 x 40 x 125 mm
Dia x Thread Length x Total Length = 4 x 40 x 150 mm
Dia x Thread Length x Total Length = 4 x 40 x 175 mm

Dia x Thread Length x Total Length = 4.5 x 20 x 60 mm
Dia x Thread Length x Total Length = 4.5 x 20 x 80 mm
Dia x Thread Length x Total Length = 4.5 x 30 x 100 mm
Dia x Thread Length x Total Length = 4.5 x 40 x 125 mm
Dia x Thread Length x Total Length = 4.5 x 40 x 150 mm
Dia x Thread Length x Total Length = 4.5 x 40 x 175 mm

Dia x Thread Length x Total Length = 5.0 x 30 x 100 mm
Dia x Thread Length x Total Length = 5.0 x 40 x 125 mm
Dia x Thread Length x Total Length = 5.0 x 60 x 150 mm
Dia x Thread Length x Total Length = 5.0 x 60 x 175 mm
Dia x Thread Length x Total Length = 5.0 x 80 x 200 mm
Dia x Thread Length x Total Length = 5.0 x 80 x 250 mm

Dia x Thread Length x Total Length = 5.5 x 30 x 100 mm
Dia x Thread Length x Total Length = 5.5 x 40 x 125 mm
Dia x Thread Length x Total Length = 5.5 x 60 x 150 mm
Dia x Thread Length x Total Length = 5.5 x 60 x 175 mm
Dia x Thread Length x Total Length = 5.5 x 80 x 200 mm
Dia x Thread Length x Total Length = 5.5 x 80 x 250 mm

Dia x Thread Length x Total Length = 6 x 30 x 100 mm
Dia x Thread Length x Total Length = 6 x 40 x 125 mm
Dia x Thread Length x Total Length = 6 x 60 x 150 mm
Dia x Thread Length x Total Length = 6 x 60 x 175 mm
Dia x Thread Length x Total Length = 6 x 80 x 200 mm
Dia x Thread Length x Total Length = 6 x 80 x 250 mm

Dia x Thread Length x Total Length = 6.5 x 80 x 200 mm
Dia x Thread Length x Total Length = 6.5 x 80 x 225 mm
Dia x Thread Length x Total Length = 6.5 x 80 x 250 mm
Dia x Thread Length x Total Length = 6.5 x 90 x 275 mm
Dia x Thread Length x Total Length = 6.5 x 100 x 300 mm

Schanz Pin Tapered Threaded Sizes

Dia x Thread Length x Total Length = 4.5-3.5 x 20 x 80
Dia x Thread Length x Total Length = 4.5-3.5 x 20 x 100

Dia x Thread Length x Total Length = 4.5-3.5 x 30 x 100
Dia x Thread Length x Total Length = 4.5-3.5 x 30 x 120
Dia x Thread Length x Total Length = 4.5-3.5 x 30 x 140

Dia x Thread Length x Total Length = 4.5-3.5 x 40 x 120
Dia x Thread Length x Total Length = 4.5-3.5 x 40 x 140
Dia x Thread Length x Total Length = 4.5-3.5 x 40 x 160

Dia x Thread Length x Total Length = 6-5 x 30 x 100
Dia x Thread Length x Total Length = 6-5 x 30 x 120
Dia x Thread Length x Total Length = 6-5 x 30 x 140
Dia x Thread Length x Total Length = 6-5 x 30 x 160

Dia x Thread Length x Total Length = 6-5 x 40 x 140
Dia x Thread Length x Total Length = 6-5 x 40 x 160
Dia x Thread Length x Total Length = 6-5 x 40 x 180
Dia x Thread Length x Total Length = 6-5 x 40 x 200

Dia x Thread Length x Total Length = 6-5 x 50 x 160
Dia x Thread Length x Total Length = 6-5 x 50 x 180
Dia x Thread Length x Total Length = 6-5 x 50 x 200
Dia x Thread Length x Total Length = 6-5 x 50 x 220

Dia x Thread Length x Total Length = 6-5 x 60 x 180
Dia x Thread Length x Total Length = 6-5 x 60 x 200
Dia x Thread Length x Total Length = 6-5 x 60 x 220
Dia x Thread Length x Total Length = 6-5 x 60 x 240

Dia x Thread Length x Total Length = 6-5 x 70 x 200
Dia x Thread Length x Total Length = 6-5 x 70 x 220
Dia x Thread Length x Total Length = 6-5 x 70 x 240

Dia x Thread Length x Total Length = 6-5 x 80 x 220
Dia x Thread Length x Total Length = 6-5 x 80 x 250

Schanz Pin Indications for Use

Schanz Pin is intended for use with an external fixation system for fracture fixation (open or closed); pseudoarthrosis or nonunion of long bones; limb lengthening by epiphyseal or metaphyseal distraction; correction of bony or soft tissue deformity; correction of segmental bony or soft tissue deformity; correction of segmental bony or soft tissue defects; and joint arthrodesis.

The chosen diameter of the Schanz Pin depends on the system that is selected for a particular fracture and on the bone size. For example, for a tibial fracture, Schanz Pin with a diameter of 5 mm are used (2.5 mm Kirschner wires or threaded pins are used for the small fixator).

Preoperative Planning for Schanz Pins

Surgical approach to the tibia with Schanz Pin

The soft tissue zone through which Schanz Pins can be inserted without damaging important structures (vessels, nerves, muscles and tendons) is anteromedial to the tibia. The angles of this safe zone vary.

If the lateral surface of the distal third of the tibia is avoided, damage to the anterior tibial artery can be avoided.

If the ventral zone of the distal tibia is avoided, interference with the tendons can also be avoided.

Preoperative Planning for Schanz Pins Tibia

Surgical approach to the femur with Schanz Pin

A lateral approach to the femur within a 30° angle is recommended. A medial approach is also possible from a distal direction.

Preoperative Planning for Schanz Pins Femur

Surgical approach to the pelvis with Schanz Pin

There are two recommended options for pin placement of the external fixation assembly in the pelvis.

Supraacetabular pin placement
Given the pronounced bone structure, the more technically difficult supraacetabular pin placement is preferred over that of the iliac crest. Proceeding from the superior anterior crest, the site of entry is approximately 4–6 cm in a caudal direction, and 3–4 cm in a medial direction.
When the patient is in a supine position, the alignment for drilling the Pins is angled approximately 20° in a cranial direction and 30° inward.

Iliac crest pin placement
Precaution: To keep from damaging the femoral cutaneous nerve, avoid insertion up to 15 mm in a dorsal direction from the superior anterior iliac
spine.

The orientation of the os ilium can be determined by palpation with a finger or an additional instrument. The Pins are then inserted delicately between the two laminae of the os ilium.

Preoperative Planning for Schanz Pins Plevis

Approach to the humerus with Schanz Pin

Distally, a dorsal approach to the humerus is appropriate.
Precautions: When dealing with the humerus, primary consideration should be given to the radial and axillary nerves. Distally, a dorsal approach to the humerus is appropriate. Proximally, it is recommendable to introduce the Schanz Pins from a ventrolateral direction, caudal to the path of the axillary nerve.

Preoperative Planning for Schanz Pins Humerus

Technique for the placement of Schanz Pin into bone using minimal radiologic control

The insertion of Schanz Pin into the bone during external-fixation procedures in trauma and elective orthopaedic surgery is usually done under röentgenologic control. In order to minimize irradiation exposure for the patients, as well as surgeons, we describe a simple method of Schanz Pin placement. The röentgenologic control of the position of the half-pins is only necessary at the beginning and the end of the procedure. This technique is simple, shortens the operating time and reduces the amount of radiation exposure to both the patient and surgeon. It is a valuable technique in many resource-poor environments who do not have the facilities for an image intensifier fluoroscopy or C-arm as well as in austere situations such as during military operations.

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Schanz Pin Contraindications

Contraindications may be qualified or total, and need to be taken into consideration when evaluating the prognosis in each case. The physician’s education, training and professional judgement must be relied upon to choose the most appropriate device and treatment. Conditions presenting an increased risk of failure include:

  • Any active or suspected latent infection or marked local inflammation in or about the affected area.
  • Compromised vascularity that would inhibit adequate blood supply to the fracture or the operative site.
  • Bone stock compromised by disease, infection or prior implantation that can not provide adequate support and/or fixation of the devices.
  • Material sensitivity, documented or suspected.
  • Obesity. An overweight or obese patient can produce loads on the implant that can lead to failure of the fixation of the device or to
    failure of the device itself.
  • Patients having inadequate tissue coverage over the operative site.
  • Implant utilization that would interfere with anatomical structures or physiological performance.
  • Any mental or neuromuscular disorder which would create an unacceptable risk of fixation failure or complications in postoperative care.
  • Other medical or surgical conditions which would preclude the potential benefit of surgery.
  • All associated diseases which could endanger the function and success of the Schanz Pin.

Warnings and Precautionary for Schanz Pin

Before using Schanz 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.

Pin is made from medical grade materials and are designed, constructed and produced with utmost care. These quality Pin 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  Pin 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 implants.

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 Pin, 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 Schanz Pin.
  • Mechanical failure of the implant, including bending, loosening or breakage.
  • Migration of implant resulting in injury.

Preoperative Planning for Schanz 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 size of Schanz Pin must be available.

The clinician should discuss with the patient the possible risks and complications associated with the use of implants. 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.

Schanz Pin Precautions

  • Confirm functionality of instruments and check for wear during reprocessing. Replace worn or damaged instruments prior to use.
  • It is recommended to use the instruments identified for this Pin.
  • Handle devices with care and dispose worn bone cutting instruments in a sharps container.
  • Always irrigate and apply suction for removal of debris potentially generated during implantation or removal.

Schanz Pin Warnings

  • Schanz Pin can break during use (when subjected to excessive forces). While the surgeon must make the final decision on removal of the broken part based on associated risk in doing so, we recommend that whenever possible and practical for the individual patient, the broken part should be removed. Be aware that implants are not as strong as native bone. Implants subjected to substantial loads may fail.
  • Instruments, screws and cut plates may have sharp edges or moving joints that may pinch or tear user’s glove or skin.
  • Take care to remove all fragments that are not fixated during the surgery.
  • While the surgeon must make the final decision on implant removal, we recommend that whenever possible and practical for the individual patient, fixation devices should be removed once their service as an aid to healing is accomplished. Pin removal should be followed by adequate post-operative management to avoid refracture.

Schanz Pin General Adverse Events

As with all major surgical procedures, risks, side effects and adverse events can occur. While many possible reactions may occur, some of the most common include: Problems resulting from anesthesia and patient positioning (e.g. nausea, vomiting, dental injuries, neurological impairments, etc.), thrombosis, embolism, infection, nerve and/or tooth root damage or injury of other critical structures including blood vessels, excessive bleeding, damage to soft tissues incl. swelling, abnormal scar formation, functional impairment of the musculoskeletal system, pain, discomfort or abnormal sensation due to the presence of the device, allergy or hypersensitivity reactions, side effects associated with hardware prominence, loosening, bending, or breakage of the device, mal-union, non-union or delayed union which may lead to breakage of the Schanz Pin, reoperation.

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