From the Research
The calf pin approach in the emergency room is not a recommended technique for temporary stabilization of lower leg fractures, as the provided evidence does not support its use in this context. When considering temporary stabilization of lower leg fractures, particularly tibial shaft fractures, in the emergency room, it is essential to prioritize techniques that are evidence-based and minimize complications. The most recent and highest quality study, 1, discusses the use of external fixation in the emergency department, emphasizing its application in critically ill patients for life-saving attempts, such as stabilization of the pelvis, tibia, femur, and humerus. However, this study does not mention the calf pin approach as a recommended technique for temporary stabilization of lower leg fractures. Other studies, such as 2, 3, and 4, provide information on the management and treatment options for tibial shaft fractures and unstable pelvic fractures but do not support the use of the calf pin approach in the emergency room. Given the lack of evidence supporting the calf pin approach, it is recommended to use alternative techniques, such as external fixation or intramedullary nailing, for temporary stabilization of lower leg fractures in the emergency room, as these methods are supported by higher quality evidence. Key considerations for temporary stabilization include:
- Using a technique that provides stable fixation and promotes early motion
- Minimizing morbidity and preventing further soft tissue damage
- Facilitating patient transport or transfer
- Regular pin site care with sterile dressings and monitoring for signs of infection or neurovascular compromise until definitive fixation can be performed.