Pin Tract Infections after the Use of Ilizarov Type Circular External Fixator

Abstract

Purpose: We planned our study to be based on to determine the rations and defining the causes of pin-tract infections which were encountered in Ilizarov type circular extemal fixator applications, used widely as a treatment modality in the orthopaedical and traumatological problems during the last years.
Patients and methods: We searched the pin-tract infections in 37 male (80.4%) and 9 female (19.6%) patients having fractures treated with Ilizarov type Circular fixators with a total of 46 cases. The mean age was 27.4 months (16-71 months) and mean follow up time was 9.2 months (4-23 months). 431 K wires were introduced to the 69 discrete bones of all 46 cases. Of 431 K wires, 365 of them were trochar ended while 66 of them were bayonet ended, 348 were straight while 83 of them were olived. The wires were implanted with a speed of 25-50 cyGe/min and stretched under 50-120 kg force with the help of a dynamometer. No soft tissue infections were encountered along the way of wire applications.
Results: The infections were along the tract of each 54 (12.5%) wires of 22 (47.8%) cases of the total 46. These infections were as soft tissue inflammation (grade 1) in 41 cases and soft tissue infection (grade 2) in 13 cases. None of the cases revealed grade 3 bone infection. The emerging times of the infections at the site of entrance were during the first 60 days in 13 cases; the second 60 days in 41 cases (p=0.0001). No microorganism was cultured with microbiological investigations in the cases of soft tissue inflammation or the cases with discharge. In soft tissue infection cases 7 (53.8%) of them revealed the existence of staphylococcus aureus and 6 (46.2%) of them staphylococcus epidermidis. All cases were treated with pin site dressing and proper antibiotherapies.
Discussion: Today, external fixators are being widely in use particularly in traumatological problems such as open fractures, multiple closed and comminuted fractures and pseudoarthrosis and in the correction of various contractures and deformities. Besides many advantages, it increments morbidity and mortality by causing complications such as vessel-nerve lacerations and pin-tract infections. In the literature, the incidence of pin-tract infections of Ilizarov has long been given as brief information in the extents of each study. These rates have well shown correlation with our as 12.5%.
Conclusion: As a results, consistent with the literature, statistically considerable correlation were obtained with wire ends, the residency time of wires, soft tissue enhanced places and pin tract infections.