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Published on: March 24, 2019
Pin-tract infection during limb lengthening using external fixation
Valentin Antoci1, Craig M Ono, Valentin Antoci
1Department of Orthopaedic Surgery and Rehabilitation, Texas Tech University, Health Sciences Center, Paul L. Foster School of Medicine, El Paso, Texas, USA. viantoci@hotmail.com
Abstract:
We evaluated the incidence of pin-tract infection (PTI) during limb lengthening using external fixation in 88 patients and the effects of infection on final outcomes and incidence of additional procedures. The PTI rate was 96.6%. The rate of half-pin site infection was significantly (P<.05) higher in half-pin fixators (100%) than in hybrid fixators (78%). There was a significantly (P<.05) higher incidence of half-pin site infection (78%) than fine-wire site infection (33%). The rate of additional surgeries for treating PTI was higher for half-pin sites than for fine-wire sites. Three (3.4%) of the 88 cases led to chronic osteomyelitis. Careful insertion and a simple, well-defined, excellent pin-care protocol can minimize PTI.
Insights
Pin-tract infection (PTI) is common in limb lengthening, with half-pin sites having higher infection rates than fine-wire sites. Proper pin care can help minimize PTI complications.
Area of Science:
- Orthopedics
- Infectious Disease
Background:
- Limb lengthening using external fixation is a common orthopedic procedure.
- Pin-tract infection (PTI) is a known complication associated with external fixation devices.
Purpose of the Study:
- To evaluate the incidence of pin-tract infection (PTI) in patients undergoing limb lengthening with external fixation.
- To assess the impact of PTI on final outcomes and the need for additional procedures.
- To compare infection rates between different types of external fixators.
Main Methods:
- Retrospective evaluation of 88 patients undergoing limb lengthening with external fixation.
- Data collection on PTI incidence, type of fixator used (half-pin vs. hybrid), and pin site type (half-pin vs. fine-wire).
- Analysis of infection rates, need for additional surgeries, and development of chronic osteomyelitis.
Main Results:
- The overall PTI rate was 96.6%.
- Half-pin site infections were significantly more frequent (100%) in half-pin fixators compared to hybrid fixators (78%).
- Half-pin sites (78%) had a significantly higher infection incidence than fine-wire sites (33%).
- Additional surgeries for PTI were more common for half-pin sites.
- Three cases (3.4%) progressed to chronic osteomyelitis.
Conclusions:
- Pin-tract infection is highly prevalent in limb lengthening using external fixation.
- Half-pin fixators and half-pin sites are associated with a higher risk of infection.
- Implementing careful insertion techniques and a robust pin-care protocol is crucial for minimizing PTI and its complications.
