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Rates of refracture associated with external fixation in pediatric femur fractures
Kelly D Carmichael1, James Bynum, Nicholas Goucher
1Department of Orthopaedics and Rehabilitation, 301 University Blvd, University of Texas Medical Branch, Galveston, TX 77555-0165, USA. kdcarmic@utmb.edu
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External fixation for pediatric femur fractures shows high rates of pin-track infections (54.5%) and refractures (4.5%) in a small study. Combined literature data reveal 33.1% pin-track infections and 4.7% refractures.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Trauma surgery
Background:
- External fixation is a common treatment for pediatric femur fractures.
- Early complication rates require thorough investigation to optimize patient outcomes.
Purpose of the Study:
- To evaluate early complication rates of pediatric femur fractures treated with external fixation.
- To compare institutional complication rates with existing literature data.
Main Methods:
- A retrospective review of 22 pediatric patients with femur fractures treated by external fixation.
- Comparison of collected data with published literature on external fixation complications.
Main Results:
- In the institutional series, pin-track infections occurred in 54.5% of patients, with loss of reduction in 9.1%, pin-track abscess in 4.5%, and refracture in 4.5%.
- Pooled data from literature showed overall refracture rates of 4.7% and pin-track infection rates of 33.1%.
- Factors associated with refractures included open fractures, bilateral fractures, and prolonged fixator duration.
Conclusions:
- External fixation for pediatric femur fractures is associated with a high incidence of pin-track infections.
- Refracture risk is elevated in cases of open or bilateral fractures and with longer external fixation periods.
Abstract:
We conducted a small retrospective study of rates of early complications associated with external fixation of pediatric femur fractures and compared rates at our institution with those reported in the literature. In our series of 22 patients, early complications included 12 pin-track infections (54.5%), 2 cases of loss of reduction (9.1%), 1 pin-track abscess (4.5%), and 1 refracture (4.5%). Overall rates (ours combined with those reported by other investigators) were 4.7% (34/719) for refractures and 33.1% (224/677) for pin-track infections. Factors that correlated with refractures were open fracture, bilateral fracture, and longer time in fixator. Factors with inconclusive correlations were fracture pattern, dynamization status, fixator type, pin size, and number of pins.
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