Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Costa del Sol, University of Malaga, Marbella (Malaga), Spain.
Department of Orthopaedic Surgery and Traumatology, Hospital Universitario Costa del Sol, University of Malaga, Marbella (Malaga), Spain.
Injury. 2019 Jun;50 Suppl 1:S45-S49. doi: 10.1016/j.injury.2019.03.044. Epub 2019 Apr 1.
Pin tract infection in external fixation (ExFix) is a frequent finding which can eventually lead to loosening, osteomyelitis and loss of fixation. Its diagnosis is based on high empiricism and low validity, although it is possible to distinguish between minor and major infection. The first is limited to soft tissues, whereas the latter includes bone involvement. The rate of infection after conversion of external fixation to intramedullary nailing (IMN) is not well known. Unfortunately, papers referring to infection after the conversion of ExFix to intramedullary nailing (IMN) are of evidence level IV or V. It is suggested that conversion of ExFix to IMN should be carried out in a 2 step regimen. The time interval of 2 step regimen is uncertain although some authors have recommended to occur within 9 days. There is no consensus as to which prophylaxis protocol should be applied prior to conversion. In order to throw more light into this important issue, registries capturing important related parameters to the development of infection should be established.
外固定器（ExFix）的钉道感染是一种常见的情况，最终可能导致松动、骨髓炎和固定丢失。其诊断主要基于经验，准确性较低，虽然可以区分轻度和重度感染。前者仅限于软组织，而后者则包括骨感染。外固定器转换为髓内钉（IMN）后的感染率尚不清楚。不幸的是，关于外固定器转换为髓内钉（IMN）后感染的论文的证据水平为 IV 或 V 级。建议将外固定器转换为髓内钉采用两步法。两步法的时间间隔不确定，尽管有些作者建议在 9 天内进行。对于转换前应应用哪种预防方案，尚无共识。为了更深入地了解这个重要问题，应该建立登记处，以收集与感染发展相关的重要参数。
