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Therefore, 12 mm of the cortical button in addition to the inserter tip needs to extend past the distal cortical surface.

The cortical button we used is 12 mm in length and 2.6 mm in width. Despite these factors, our study still showed contact with the nerve with half the specimens and close proximity of the nerve when seated. The secondary dissection could potentially result in displacement of tissue away from the cortical button and thereby increase space for soft tissues to move away from the cortical button as the soft tissue envelope is further released.

In addition, the posterolateral incision used to directly observe the cortical button during deployment and seating could have disturbed the surrounding tissues, which would otherwise be untouched in a single-incision surgery with a live patient. ( Fig. 7).Ī potential limitation of this study is the small number of specimens. Then, we assessed for potential entrapment of the nerve under the cortical button and recorded the final seated distance of the cortical button from the nerve using a medical ruler and minimal retraction to minimize soft tissue distortion. The sutures were sequentially tensioned, which allowed the tendon to be reduced down to the surface of the bone under direct visualization. We then proceeded with cortical button seating. We then recorded if there was contact at any point with any aspect of the cortical button. When the cortical button was clear of the distal cortex, we observed for contact between the PIN and cortical button. We used minimal retraction to limit the distortion of natural anatomy while providing the ability to determine distance. At this point, we assessed for potential entrapment of the nerve under the cortical button and measured the distance of the seated cortical button to the nerve using a medical ruler. Clearance of the distal cortex was confirmed using fluoroscopy ( Fig. 6). At this point, we directly observed the distance between the deployed cortical button and the PIN before seating. The cortical button was then placed directly into the proximal radius using the supplied inserter (Arthrex).