title: From prevention of pin-tract infection to treatment of osteomyelitis during paediatric external fixation.
abstract: Pin-tract infection (PTI) is the most commonly expected problem, or even an almost inevitable complication, when using external fixation. Left unteated, PTI will progress unavoidably, lead to mechanical pin loosening, and ultimately cause instability of the external fixator pin-bone construct. Thus, PTI remains a clinical challenge, specifically in cases of limb lengthening or deformity correction. Standardised pin site protocols which encompass an understanding of external fixator biomechanics and meticulous surgical technique during pin and wire insertion, postoperative pin site care and pin removal could limit the incidence of major infections and treatment failures. Here we discuss concepts regarding the epidemiology, physiopathology and microbiology of PTI in paediatric populations, as well as the clinical presentations, diagnosis, classification and treatment of these infections.
authors.affiliation: Division of Paediatric Orthopaedics, University Hospitals of Geneva, Geneva, Switzerland. dimitri.ceroni@hcuge.ch.
authors.forename: Dimitri
authors.initials: D
authors.lastname: Ceroni
authors.affiliation: Ambulatory Nursing Care Consultation for Paediatric External Fixators, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Catherine
authors.initials: C
authors.lastname: Grumetz
authors.affiliation: Ambulatory Nursing Care Consultation for Paediatric External Fixators, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Odile
authors.initials: O
authors.lastname: Desvachez
authors.affiliation: Ambulatory Nursing Care Consultation for Paediatric External Fixators, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Sophie
authors.initials: S
authors.lastname: Pusateri
authors.affiliation: Ambulatory Nursing Care Consultation for Paediatric External Fixators, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Pierre
authors.initials: P
authors.lastname: Dunand
authors.affiliation: Division of Paediatric Orthopaedics, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Eleftheria
authors.initials: E
authors.lastname: Samara
keywords: Half-pin; Infection; Instability; Pin; Tract; Wire