Many authors advocate that great efforts should be made to ensure that not only pin and wire insertion is as atraumatic as possible for the skin, but also for soft tissue and bone, thereby minimising iatrogenic damage to these structures. Thus, the location or placement of the pin must be considered carefully. Skin incisions should only be as large as the diameter of the pin [
18], and these incisions should be made with care in order to avoid tension on the skin. Immediate subcutaneous bone surfaces are preferable, since pins located in areas with considerable soft tissue, tendons and tendon sheaths are at the greatest risk of infection [
38,
39]. Wires should not be drilled through to soft tissue, but rather pushed into the near cortex, then drilled through the bone and finally advanced through the opposite soft tissue by tapping with a mallet [
40]. Any muscle compartment traversed during the placement pins or wires should be placed under stretch [
38,
39] in order to prevent transfixing muscles in a shortened position [
38,
39]. Heat generation must be avoided during pin or wire insertion, as this could lead to thermal necrosis of the surrounding bone, ring sequestra and pin loosening. Thus, the anterior tibial crest should be avoided at all cost, as drilling through the thick cortical bone can generate excessive heat [
18,
38]. It is thus advisable to drill using continuous cold saline irrigation to ensure proper pin cooling [
17]. For half-pin placement, pre-drilling should always be performed, even when using self-drilling pins [
38]. After drilling, the pilot hole must be irrigated to remove any bone swarf that might act as sequestra and prevent optimal bone–pin fixation [
17,
18]. Finally, many authors follow Davies’ recommendations and, as far as possible, use a no-touch technique when inserting half-pins [
17,
18]. To ensure a no-touch technique for inserting wires, chlorhexidine or alcoholic iodine-soaked swabs are used to handle and manipulate wire placement. The immediate use of pressure dressings and the removal of any blood from the skin, especially around the pin site, also lessen the proliferation of bacteria within a haematoma and minimise pin–skin motion.