Hydroxyapatite-coated external-fixation pins. The effect on pin loosening and pin-track infection in leg lengthening for short stature.
Pin loosening and infection are inherent complications of external fixation. This study deals with their effects of using either hydroxyapatite (HA)-coated or uncoated external fixation pins in leg-lengthening procedures on patients of short stature. We used HA-coated pins on one side and uncoated pins on the other (randomly determined) in 28 bilateral lengthenings undertaken in 23 patients. A total of 322 pins was used. The mean implantation time was 530 days and the mean lengthening achieved was 78% of initial bone length. Mean extraction torque was 7611.6 Nmm degree(-1) for HA-coated and 85.4 Nmm degree(-1) for uncoated pins (p < 0.001). The rate of pin loosening was 4% (7/161) for HA-coated and 80% (129/161) for uncoated pins (p < 0.001). There was no statistically significant difference in the incidence of pin-track infection between the two groups. The use of HA coating appears to be an effective method of reducing the incidence of pin loosening in external fixation with a long implantation time and for mechanically highly stressed procedures such as leg lengthening for short stature.
Universitari Germans Trias i Pujol, Badalona and Hospital Universitari Vail D'Hebron, Barcelona, Spain.
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D000293:Adolescent; D001672:Biocompatible Materials / Q000008:administration & dosage; D001848:Bone Diseases, Developmental / Q000601:surgery*; D001852:Bone Lengthening / Q000379:methods*; D001858:Bone Nails; D017886:Durapatite / Q000008:administration & dosage; D004868:Equipment Failure; D016267:External Fixators; D005260:Female; D006130:Growth Disorders / Q000601:surgery*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*
D001672:Biocompatible Materials; D017886:Durapatite