What is the correct sequence for tightening HALO pins?

The correct sequence for tightening HALO pins is to tighten diagonally opposed pins together. This method is essential because it ensures even distribution of forces across the skull and the frame. By tightening the pins in a diagonally opposed manner, you help maintain stability and minimize the risk of creating uneven pressure, which could lead to complications such as pin loosening or discomfort for the patient.

Tightening all pins in a clockwise direction could lead to an uneven application of force, which is not optimal for maintaining alignment and stability over the entire construct. Sequentially tightening from top to bottom could also lead to unequal pressure distribution, increasing the risk of complications. Lastly, tightening all pins equally at the same time can be problematic as it may not allow for correction or adjustments needed to ensure that the frame remains properly positioned.

Thus, the diagonally opposed approach significantly enhances safety and efficacy in the HALO application process.