title: Does routine pin re-torquing of patients wearing a halo-thoracic orthosis reduce the need for pin replacement?
abstract: BACKGROUND
  The halo orthosis is a treatment option currently used in Australia for cervical spine immobilisation following trauma, fracture and post surgical stabilisation. In a previous study, the authors reported halo pin replacement to be a common complication. The aim of this study was to investigate the potential correlation between routine halo pin re-torquing and the incidence of pin replacement.
  
  
  METHODS
  A retrospective case series study was undertaken. A total of 258 charts were reviewed, with 170 patients included in the study. Patients were fitted with a Bremer HALO System with the initial application torque maintained by routine re-torquing throughout the duration of wear.
  
  
  RESULTS
  A total of 680 pins (4 per patient) were inserted during the initial application of the halo orthoses, with only six pins replaced (0.88%) throughout the duration of the study.
  
  
  CONCLUSIONS
  The findings from this study demonstrate a potential correlation between routinely re-torquing halo pins and decreasing the incidence of pin replacement.
  
  
  CONCLUSIONS
  This case series study has identified a potential improvement in clinical management of patients wearing a halo-thoracic orthosis.
authors.affiliation: Princess Alexandra Hospital, Brisbane, QLD, Australia dan.sue.fraser@gmail.com.
authors.forename: Sue
authors.initials: S
authors.lastname: Fraser
authors.affiliation: Princess Alexandra Hospital, Brisbane, QLD, Australia.
authors.forename: John P
authors.initials: JP
authors.lastname: Coffey
mesh_terms: D000328:Adult; D001858:Bone Nails; D002574:Cervical Vertebrae / Q000293:injuries; D005260:Female; D006801:Humans; D007103:Immobilization; D008297:Male; D009989:Orthotic Devices; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000628:therapy*; D013314:Stress, Mechanical; D019415:Torque
keywords: Halo-thoracic; halo pin