title: Pin-site complications of the halo thoracic brace with routine pin re-tightening.
abstract: METHODS
  Retrospective analysis with historic controls.
  
  
  OBJECTIVE
  To analyze pin-site complications in a large series of halo thoracic braces in which regular re-tightening of the pins was performed.
  
  
  BACKGROUND
  Perry and Nickel first described the use of the halo thoracic brace in 1959 for cervical immobilization. Its use has been extended successfully to cervical fracture management.
  
  
  METHODS
  A total of 266 commercially available halo thoracic braces were fitted using a standard technique. All pins were tightened routinely at 24 hours and at 1 week after application. Two data sources, prosthetic department records and patients' medical records, were analyzed.
  
  
  RESULTS
  Six percent of patients had a pin-site infection; 3.7% had loose pins, and 1.1% reported pin-site pain. No subdural, intradural, or extradural abscess or cerebrospinal fluid leaks occurred. A total of 2.6% of halo rings slipped off, and 2.3% of patients experienced severe headaches.
  
  
  CONCLUSIONS
  Low rates of pin-site infection, loosening, and pain were achieved through routine re-tightening of the pins. Pin re-tightening, at 24 hours and at 1 week after application, is a safe and effective method to decrease pin-site complications.
authors.affiliation: Department of Orthopaedic Surgery, Princess Alexandra Hospital, Brisbane, Australia. C.Vertullo@mailbox.uq.edu.au
authors.forename: C J
authors.initials: CJ
authors.lastname: Vertullo
authors.forename: P F
authors.initials: PF
authors.lastname: Duke
authors.forename: G N
authors.initials: GN
authors.lastname: Askin
mesh_terms: D000328:Adult; D001858:Bone Nails / Q000009:adverse effects*; D002574:Cervical Vertebrae / Q000293:injuries*; D016267:External Fixators; D005260:Female; D006261:Headache / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007239:Infections / Q000453:epidemiology / Q000209:etiology; D008297:Male; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000628:therapy*; D013997:Time Factors; D014143:Traction / Q000295:instrumentation