title: The "Good, Bad and Ugly" pin site grading system: A reliable and memorable method for documenting and monitoring ring fixator pin sites.
abstract: Although there is much in the literature regarding pin site infections, there is no accepted, validated method for documenting their state. We present a system for reliably labelling pin sites on any ring fixator construct and an easy-to-remember grading system to document the state of each pin site. Each site is graded in terms of erythema, pain and discharge to give a 3-point scale, named "Good", "Bad" and "Ugly" for ease of recall. This system was tested for intra- and inter-observer reproducibility. 15 patients undergoing elective limb reconstruction were recruited. A total of 218 pin sites were independently scored by 2 examiners. 82 were then re-examined later by the same examiners. 514 pin sites were felt to be "Good", 80 "Bad" and 6 "Ugly". The reproducibility of the system was found to be excellent. We feel our system gives a quick, reliable and reproducible method to monitor individual pin sites and their response to treatment.
authors: Paediatric and Limb Reconstruction Unit, Royal National Orthopaedic Hospital, Stanmore, United Kingdom. simonaclint@googlemail.com
authors: S A
authors: SA
authors: Clint
authors: D M
authors: DM
authors: Eastwood
authors: M
authors: M
authors: Chasseaud
authors: P R
authors: PR
authors: Calder
authors: D R
authors: DR
authors: Marsh
mesh_terms: D001858:Bone Nails / Q000009:adverse effects*; D002985:Clinical Protocols; D005264:Femoral Fractures / Q000601:surgery; D006801:Humans; D018889:Ilizarov Technique / Q000295:instrumentation*; D015588:Observer Variation; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000209:etiology; D015203:Reproducibility of Results; D013978:Tibial Fractures / Q000601:surgery; D016896:Treatment Outcome