Effect of Bidirectional Insertion of External Skeletal Fixation Pins on Axial Pullout Strength in Canine Cadaveric Bone.

 The authors recommend that pins used for external skeletal fixation should be placed unidirectionally to the desired position with fluoroscopic guidance, intra-operative depth gauge measurements or measurements from preoperative radiographs. Repositioning pins results in loss of peak pullout strength with TRO and PP pins.