Safe Localization for Placement of Percutaneous Pins in the Calcaneus.

OBJECTIVE To determine the areas presenting risk in six zones of the calcaneus, and to quantify the risks of injury to the anatomical structures (artery, vein, nerve and tendon). METHOD Fifty-three calcanei from cadavers were used, divided into three zones and each subdivided in two areas (upper and lower) by means of a longitudinal line through the calcaneus. The risk of injury to the anatomical structures in relation to each Kirschner wire was determined using a graded system according to the Licht classification. The total risk of injury to the anatomical structures through placement of more than one wire was quantified using the additive law of probabilities and the product law for independent events. RESULTS The injury risk calculation according to the Licht classification showed that the highest risk of injury to the artery or vein was in zone IA (43%), in relation to injuries to nerves and tendons (13% and 0%, respectively). CONCLUSION This study made it possible to identify the most vulnerable anatomical structures and quantify the risk of injury to the calcaneus.