UKBB, University Childrens Hospital Basel, Department of Orthopaedics, Spitalstrasse 33, 4056 Basel, Switzerland.
Injury. 2012 Nov;43(11):1969-73. doi: 10.1016/j.injury.2012.08.010. Epub 2012 Aug 16.
Pin site infections are seen in up to 40% of external fixators (ExFix) and are therefore the most common complication with this device. There is no consensus in the literature as to the appropriate regimen for pin tract care and infection prevention. This study is the first intra-subject, randomised, prospective controlled trial comparing daily pin tract care to no pin tract care at all.
Consecutive patients series (56 patients, 16 female, age 4-68 y, mean 24 y, in total 204 pins) recruited in the National Referral Hospital in Honiara in the Solomon Islands over a 2 year period. Exclusion criteria were application of ExFix for less than two weeks or a non-standard ExFix. Pin treatment was allocated into groups anatomically, proximal and distal. Randomisation was intra-subject and intra-group: 101 pins had daily pin site care and 103 had no treatment at all.
Soft-tissue interface, stability of the pins, torsional stability as determined with a torque metre, osteolysis and pain. Assessment of pin sites blinded. Statistical analysis using the paired t test for parametric data and the Wilcoxon rank test for non-parametric data (Stat View).
No significant difference between the two groups. Soft-tissue interface 36% vs. 35% (granulation/secretion), stability 20 vs 25 pins with loosening. No significant osteolysis (7 vs. 6 pins). Torque: mean 0.75 Nm, max.: 3.05 Nm vs. 0.60 Nm, max.: 3.55 Nm, no significant difference. No differences in demographics (age, localisation, sex, time of fixation).
This study shows that routine pin tract care is unnecessary in external fixation treatment of injuries.
高达 40%的外固定器（ExFix）会出现针道感染，因此这是该设备最常见的并发症。文献中对于针道护理和感染预防的适当方案尚无共识。这项研究是首次在体内进行的随机前瞻性对照试验，比较了每天进行针道护理与完全不进行针道护理。
连续患者系列（56 名患者，16 名女性，年龄 4-68 岁，平均 24 岁，总共 204 根针）在 2 年内从所罗门群岛霍尼亚拉的国家转诊医院招募。排除标准为外固定器应用少于 2 周或非标准外固定器。针的处理按解剖部位分为近端和远端两组进行分组。随机化是在个体内和组内进行的：101 根针每天进行针道护理，103 根针根本不进行治疗。
软组织界面、针的稳定性、扭矩计测量的扭转稳定性、骨溶解和疼痛。盲法评估针道。使用配对 t 检验进行参数数据的统计分析，使用 Wilcoxon 秩检验进行非参数数据的统计分析（Stat View）。
两组之间没有显著差异。软组织界面分别为 36%和 35%（肉芽组织/分泌物），松动的针分别为 20 根和 25 根。无明显骨溶解（7 根针和 6 根针）。扭矩：平均 0.75 Nm，最大：3.05 Nm vs. 0.60 Nm，最大：3.55 Nm，无显著差异。在人口统计学方面（年龄、定位、性别、固定时间）无差异。
这项研究表明，在创伤的外固定治疗中，常规针道护理是不必要的。
