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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

American Journal of Orthopedics (Belle Mead, N.J.)
|November 5, 2008
PubMed
Summary

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.

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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.

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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.