title: Kirschner wire pin site infection in hand and wrist fractures: incidence rate and risk factors.
abstract: Kirschner wires are widely used for skeletal fixation of unstable fractures, but the pin tracks create a potential pathway through the skin and into the bone for bacteria to cause an infection. We tested the null hypothesis that there are no demographic, patient-related, injury, or treatment variables independently associated with the occurrence of pin site infection after percutaneous fixation of hand and wrist fractures using Kirschner wires. A retrospective review of 1213 patients with one or more fractures of the hand and wrist treated with percutaneous Kirschner wire fixation identified 85 patients (7%) who had additional treatment with oral antibiotics, early pin removal, or reoperation related to a pin site infection. We found no factors were independently associated with higher or lower risks of pin site infection in multivariable logistic regression analysis. Pin site infections - most benign - occur in a notable number of patients and we could not identify any modifiable risk factors.
  
  
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authors.affiliation: 1 Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, MA, USA.
authors.forename: W F
authors.initials: WF
authors.lastname: van Leeuwen
authors.affiliation: 1 Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, MA, USA.
authors.forename: B T J A
authors.initials: BT
authors.lastname: van Hoorn
authors.affiliation: 1 Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, MA, USA.
authors.forename: N
authors.initials: N
authors.lastname: Chen
authors.affiliation: 2 Department of Surgery and Perioperative Care, The University of Texas at Austin, TX, USA.
authors.forename: D
authors.initials: D
authors.lastname: Ring
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001864:Bone Wires / Q000009:adverse effects*; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation*; D050723:Fractures, Bone / Q000601:surgery*; D050276:Hand Bones / Q000293:injuries*; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: Kirschner wire; fracture; hand; infection; k-wire; percutaneous; skeletal fixation; wrist