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Published on: April 11, 2012
Pin tract infection with external fixation of pediatric fractures
Johannes Schalamon1, Thomas Petnehazy, Herwig Ainoedhofer
1Department of Pediatric Surgery, Medical University of Graz, Graz 8036, Austria. johannes.schalamon@meduni-graz.at
Insights
Pin tract infections occurred in half of pediatric trauma patients using external fixation. Most infections were mild and treatable with antibiotics, not requiring changes in stabilization methods.
Area of Science:
- Orthopedics
- Pediatric Trauma Care
- Infectious Disease Management
Background:
- External fixation is a common orthopedic technique for pediatric trauma.
- Pin tract infections (PTIs) are a potential complication of external fixation.
- Understanding PTI incidence and severity is crucial for patient management.
Purpose of the Study:
- To determine the incidence and severity of pin tract infections in pediatric trauma patients.
- To evaluate treatment outcomes for pin tract infections.
- To assess the impact of pin tract infections on external fixation management.
Main Methods:
- Retrospective review of 30 pediatric trauma patients (37 external fixation episodes) from 1998-2003.
- External fixation duration averaged 17.5 weeks.
- Pin tract infections were classified using the Dahl criteria; cultures obtained for drainage.
Main Results:
- Pin tract infections occurred in 52% of external fixation episodes (35/37).
- Most infections were mild/moderate; only 3 (9%) were severe deep infections (grade 5).
- 17% of infections resolved with local antibiotics; 77% with systemic antibiotics; 6% required pin removal.
Conclusions:
- Pin tract infections are common in pediatric external fixation but often manageable.
- Mild to moderate pin tract infections typically respond well to antibiotic therapy.
- The occurrence of pin tract infections did not necessitate altering the external fixation strategy.
Background:
This study aimed to evaluate the incidence and severity of pin tract infections in a series of pediatric trauma patients.
Methods:
All pediatric trauma patients with external fixation who were treated at our institution between 1998 and 2003 were included. The charts of 30 children (20 males; 10 females; mean age, 13.2 years; range, 7-19 years) with 37 episodes of external fixation were reviewed. The average duration of external fixation was 17.5 weeks (range, 1-94 weeks). Pin tract infections were graded using the Dahl classification. Bacterial cultures were obtained in case of drainage from the pin site.
Results:
In 18 (48%) of 37 external fixations, no signs of infection occurred during the treatment period. In the remaining 19 (52%) external fixations, 35 episodes of infection were documented. Most infections were mild or moderate, whereas only 3 (9%) severe deep infections were noted (grade 5). Six (17%) infections healed with local application of rifamycin, whereas 27 (77%) of 35 infections were successfully treated with systemic antibiotics (cefuroxime, clindamycin). The remaining 2 infections (6%) required removal of a pin.
Conclusions:
Pin tract infection occurred in half of the patients who were treated with external fixations. Most of the pin site infections in the present series were mild and could be managed by local or systemic application of antibiotics. The occurrence of pin tract infections did not require a change of the method of stabilization.
