van Leeuwen W F, van Hoorn B T J A, Chen N, Ring D
1 Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, MA, USA.
2 Department of Surgery and Perioperative Care, The University of Texas at Austin, TX, USA.
J Hand Surg Eur Vol. 2016 Nov;41(9):990-994. doi: 10.1177/1753193416661280. Epub 2016 Jul 28.
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.
III.
克氏针广泛用于不稳定骨折的骨骼固定,但针道为细菌经皮肤进入骨骼导致感染创造了潜在途径。我们检验了零假设:经皮使用克氏针固定手部和腕部骨折后,不存在与针道感染发生独立相关的人口统计学、患者相关、损伤或治疗变量。对1213例接受经皮克氏针固定治疗一处或多处手部和腕部骨折的患者进行回顾性分析,确定了85例(7%)因针道感染接受口服抗生素、早期拔针或再次手术等额外治疗的患者。在多变量逻辑回归分析中,我们未发现有因素与针道感染的高风险或低风险独立相关。针道感染——大多为良性——在相当数量的患者中发生,且我们未能识别出任何可改变的风险因素。
III级。