Pin tract infection with external fixation of pediatric fractures.
BACKGROUND
This study aimed to evaluate the incidence and severity of pin tract infections in a series of pediatric trauma patients.


METHODS
All pediatric trauma patients with external fixation who were treated at our institution between 1998 and 2003 were included. The charts of 30 children (20 males; 10 females; mean age, 13.2 years; range, 7-19 years) with 37 episodes of external fixation were reviewed. The average duration of external fixation was 17.5 weeks (range, 1-94 weeks). Pin tract infections were graded using the Dahl classification. Bacterial cultures were obtained in case of drainage from the pin site.


RESULTS
In 18 (48%) of 37 external fixations, no signs of infection occurred during the treatment period. In the remaining 19 (52%) external fixations, 35 episodes of infection were documented. Most infections were mild or moderate, whereas only 3 (9%) severe deep infections were noted (grade 5). Six (17%) infections healed with local application of rifamycin, whereas 27 (77%) of 35 infections were successfully treated with systemic antibiotics (cefuroxime, clindamycin). The remaining 2 infections (6%) required removal of a pin.


CONCLUSIONS
Pin tract infection occurred in half of the patients who were treated with external fixations. Most of the pin site infections in the present series were mild and could be managed by local or systemic application of antibiotics. The occurrence of pin tract infections did not require a change of the method of stabilization.
Schalamon
Johannes
J
Department of Pediatric Surgery, Medical University of Graz, Graz 8036, Austria. johannes.schalamon@meduni-graz.at
Petnehazy
Thomas
T
Ainoedhofer
Herwig
H
Zwick
Ernst B
EB
Singer
Georg
G
Hoellwarth
Michael E
ME
D000293:Adolescent; D000328:Adult; D001424:Bacterial Infections / Q000175:diagnosis / Q000209:etiology*; D001858:Bone Nails / Q000009:adverse effects*; D002648:Child; D016267:External Fixators / Q000009:adverse effects*; D005260:Female; D005592:Fracture Fixation / Q000009:adverse effects*; D006801:Humans; D008297:Male