title: Low Complication Rates Associated With the Application of Lower Extremity Traction Pins.
abstract: OBJECTIVE
  To quantify the infection risks of temporary lower extremity traction pins and compare these rates to nationwide and institution-specific surgical site infection rates. Additionally, to qualitatively describe pin site infections and to analyze the impact of traction pins on infection risks at associated open reduction internal fixation (ORIF) surgical sites.
  
  
  METHODS
  A retrospective case-control study.
  
  
  METHODS
  Level I Urban University Trauma Center.
  
  
  METHODS
  One hundred sixty-nine cases of traction pin application occurring in 157 unique patients extracted from a trauma patient database.
  
  
  METHODS
  Bedside application of a traction pin in the femur or tibia.
  
  
  METHODS
  Rates of 90-day and 1-year minor and major infections at pin insertion locations and at ORIF wounds associated with traction pins.
  
  
  RESULTS
  A single infection, a septic knee, was reported. There were no superficial infections or osteomyelitis cases observed. The 90-day and 1-year rates of infection were identical with a per pin infection rate of 0.6% [95% confidence interval (CI), 0.1%-3.4%], a minor infection rate of 0.0% (95% CI, 0.0%-2.3%), and a major infection rate of 0.6% (95% CI, 0.1%-3.4%). Observed rates were lower than, but statistically similar to, nationwide infection rates for open reduction procedures and similar to institution-specific infection rates for arthroplasty procedures. Infection rates at associated ORIF wounds were not increased in comparison with nationwide controls. Pin placement played a definitive role in the infection observed.
  
  
  CONCLUSIONS
  Temporary lower extremity traction pins have low infection rates and can be safely placed at the bedside. Careful pin placement and review of postinsertion radiographs is necessary to avoid iatrogenic infection.
  
  
  METHODS
  Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: *Department of Orthopaedics, Dartmouth Hitchcock Medical Center, Lebanon, NH; and †Orthopaedic Trauma and Fracture Service, Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Austin
authors.forename: Derek
authors.initials: D
authors.lastname: Donegan
authors.forename: Samir
authors.initials: S
authors.lastname: Mehta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails / Q000706:statistics & numerical data*; D015897:Comorbidity; D005260:Female; D005264:Femoral Fractures / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000517:prevention & control*; D013978:Tibial Fractures / Q000453:epidemiology / Q000601:surgery*; D014143:Traction / Q000295:instrumentation* / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D055815:Young Adult