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Pin tract infection with contemporary external fixation: how much of a problem?
A Dushi Parameswaran1, Craig S Roberts, David Seligson
1Department of Orthopaedic Surgery, University of Louisville, 210 E. Gray Street, Suite 1003, Louisville, KY 40202, USA.
Objective:
To determine the incidence of pin tract infection.DESIGN Retrospective chart review.
Setting:
Level 1 trauma center in an urban community.
Patients:
A total of 285 patients with 285 fractures over a 4-year period (1997-2001).
Intervention:
External fixation.
Main Outcome Measurement:
Incidence of pin tract infection.
Results:
Of 285 fractures, 32 (11.2%) were complicated by infection. The incidence of infection according to montage was 3.9% (3/77) for ring fixators, which was significantly different (P < 0.04) from the 12.9% incidence (23/178) for unilateral fixators and the 20.0% incidence (6/30) for hybrid fixators (P = 0.004). The incidences of pin tract infection for the unilateral fixator group and the hybrid fixator group were not significantly different.
Conclusions:
Patients with hybrid external fixators had a similar risk of pin tract infection as patients who had unilateral fixators. The infection rate in the ring fixator group was significantly lower than the hybrid external and unilateral fixator groups.
Insights
Ring external fixators showed a significantly lower pin tract infection rate compared to unilateral and hybrid fixators. Unilateral and hybrid fixators had similar infection risks in fracture treatment.
Area of Science:
- Orthopedic surgery
- Infectious disease
- Trauma care
Background:
- Pin tract infection is a common complication of external fixation in fracture management.
- Understanding the incidence and risk factors associated with pin tract infections is crucial for optimizing patient outcomes.
- External fixation devices are widely used in treating complex fractures, particularly in trauma settings.
Purpose of the Study:
- To determine the incidence of pin tract infection in patients treated with external fixation.
- To compare the incidence of pin tract infection across different types of external fixator configurations.
Main Methods:
- Retrospective chart review of 285 patients with fractures treated with external fixation over a 4-year period.
- Data collected included fracture type, external fixator configuration, and incidence of pin tract infection.
- Statistical analysis was performed to compare infection rates between different fixator types.
Main Results:
- The overall incidence of pin tract infection was 11.2% (32/285 fractures).
- Ring fixators had a significantly lower infection incidence (3.9%) compared to unilateral (12.9%) and hybrid fixators (20.0%).
- No significant difference in infection rates was observed between unilateral and hybrid external fixator groups.
Conclusions:
- Ring external fixators are associated with a lower risk of pin tract infection compared to unilateral and hybrid configurations.
- Unilateral and hybrid external fixators demonstrate similar risks for pin tract infection.
- These findings can inform the selection of external fixation devices to minimize infection complications in fracture treatment.