Kirschner wire infections in pediatric orthopaedic surgery

Area of Science:

• Pediatric Orthopedics
• Infectious Diseases
• Surgical Site Infections

Background:

• Kirschner wire infections in pediatric patients are infrequently documented.
• Understanding presentation, bacteriology, risk factors, and complications is crucial for prevention and treatment.

Purpose of the Study:

• To describe the characteristics of Kirschner wire infections in pediatric patients.
• To identify risk factors and complications associated with these infections.
• To inform prevention and treatment strategies.

Main Methods:

• Retrospective review of pediatric patients (birth to 16 years) hospitalized for Kirschner wire infection from 1995 to 2012.
• Data collected on presentation, hospital course, bacteriology, outcomes, and complications.
• Development of a management algorithm based on clinical experience.

Main Results:

• Twelve pediatric patients were identified with Kirschner wire infections.
• Common presentations included cellulitis, soft-tissue abscess, osteomyelitis, and toxic shock syndrome.
• Methicillin-sensitive Staphylococcus aureus (MSSA) and Pseudomonas aeruginosa were the most common pathogens. Complications included joint destruction and loss of range of motion.

Conclusions:

• Infected Kirschner wires are rare; superficial infections may not impede bone healing.
• A history of missed appointments or improper dressing care was noted in 60% of cases, suggesting a need for improved patient education.
• Osteomyelitis often followed pin-site drainage and failed oral antibiotics; empiric therapy should consider MSSA and Pseudomonas.