Reducing the incidence of pin site infection in hand surgery with the use of a protocol from Ilizarov

Solari, Mattia; Kapur, Benjamin; Benjamin-Laing, Harry; Klass, B.; Cheung, Graham; Brown, D. J.

doi:10.1177/1753193421991318

Cited by 7 publications

(3 citation statements)

References 12 publications

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“…In a systematic review, Karantana et al [ 33 ] found the incidence of pin site infection was 8% (range, 0% to 15%), which can be treated by pin site care and rarely requires antibiotics or early wire removal. Solari et al [ 34 ] retrospectively reviewed 200 patients treated with 369 percutaneous K-wires. Pin site infection was diagnosed in 9 patients (5%), and the wire survival rate was 99.5%.…”

Section: Discussionmentioning

confidence: 99%

Treatment of distal radius fractures using a cemented K-wire frame

Meng

et al. 2022

BMC Musculoskelet Disord

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Background This retrospective study included an alternative treatment for types A2, A3, and B1 distal radius fractures using percutaneous fixation with a cemented K-wire frame. Methods From January 2017 to January 2020, 78 patients with distal radius fractures were treated with percutaneous internal fixation using a cemented K-wire frame. There were 47 male patients and 31 female patients. The fractures were classified into types A2 (n = 10), A3 (n = 46), and B1 (n = 22). X-rays were taken immediately after surgery and after the bone had healed. Wrist function was assessed using the Mayo Wrist Score (90–100, excellent; 80–90, good; 60–80, satisfactory; < 60, poor). Patient satisfaction was assessed using the 10-cm visual analog scale. Results Neither fixation failure nor K-wire migration was found (P > 0.05). Osteomyelitis was not observed in this series. All patients achieved bone healing after a mean of 4.5 weeks (range, 4 to 8 weeks). Follow-up lasted a mean of 27 months (range, 24 to 33 months). The mean score of wrist function was 97 (range, 91 to 100). Among them, 66 results were excellent and 12 results were good. The mean patient satisfaction was 10 cm (range, 8 to 10 cm). Conclusions Percutaneous fixation with cemented K-wire frame is a safe and preferred choice for the treatment of types A2, A3, and B1 distal radius fractures. The frame provides support to prevent wire migration. The fixation technique is a minimally invasive procedure that is easy to perform. Level of Evidence Therapeutic study, Level IVa.

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Section: Discussionmentioning

confidence: 99%

Treatment of distal radius fractures using a cemented K-wire frame

Meng

et al. 2022

BMC Musculoskelet Disord

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“…Kirschner wire fixation is often used for hand and wrist fractures. There is a good deal of evidence that superficial wires are associated with a high rate of infection and that burying the wires beneath the skin decreases the frequency of this complication [70][71][72] .…”

Section: Fracture Carementioning

confidence: 99%

What’s New in Hand and Wrist Surgery

Bohn

Wise

2022

Journal of Bone and Joint Surgery

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The intent is to serve as an update of the hand surgery literature for the practicing general orthopaedic surgeon. Carpal Tunnel SyndromeCarpal tunnel syndrome is one of the most common disorders in hand surgery. Nevertheless, the optimum method for diagnosis remains controversial. A growing body of evidence suggests that electrodiagnostic studies [1][2][3][4] are not more sensitive and specific than diagnosis by ultrasound or clinical history and examination. D'Auria et al. 5 examined the role of electrodiagnostic studies compared with clinical judgment and found that the utility of electrodiagnostic studies may be greatest in patients for whom a diagnosis of carpal tunnel syndrome is questionable. Even so, electrodiagnostic studies are performed in many patients with carpal tunnel syndrome 6 . Less expensive, office-based diagnostic tools such as the Carpal Tunnel Syndrome 6 (CTS-6), a 26-point scale that incorporates aspects of the history and clinical examination to predict the probability of carpal tunnel syndrome, and ultrasound will likely supplant the routine use of electrodiagnostic studies for carpal tunnel syndrome.Strong evidence exists for the use of night splints and corticosteroid injections for early treatment of carpal tunnel syndrome. In a comparison of the 2 treatments, 100 patients with a diagnosis of carpal tunnel syndrome were randomized to a night splint or a corticosteroid injection 7 . In the 95 patients who completed follow-up, corticosteroid injections were superior in terms of nocturnal paresthesias, pain, and Boston Carpal Tunnel Questionnaire (BCTQ) function and symptom domains at 1, 3, and 6 months.A novel study on hand function with decreased sensation showed that a digital nerve block to the thumb had the greatest negative impact on dexterity and a loss of sensation in the index and long fingers caused decreased grip and chuck pinch strength, thus explaining the common symptoms of decreased dexterity and strength in patients with carpal tunnel syndrome 8 .Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJS/G899).

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“…Reported pin site infection rates vary from 2% to 35%. [2] Though antiseptics are used by many surgeons to prevent pin site infections, clear-cut evidence to support their use remains uncertain. Also the recommendation for the frequency of pin site care varies from four times a day to as much as once in a week.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Pin Site Infection Rate between Schanz Screws and K-Wires in Ilizarov Fixator for Tibial Fracture

Ahmad¹,

Ullah

Izhar³

et al. 2022

clin. med. & helt. res. jour.

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Objective: Comparison of pin site infection rate between schanz screws and k-wires in ilizarov fixator for tibial fracture Methodology: It was a randomized control trial, conducted at department of Orthopedics, Khyber Teaching Hospital, MTI, and Peshawar from July 2021 to June 2022. Sampling Technique was Non-probability consecutive sampling. Patients were divided into two groups using computer generated random sequence number. Patients in group A were stabilized using K-wires and patients in group B were stabilized using k-wire and schanz screws. Data were entered in specially designed proforma. Result: Mean age in group A patients was 35±2.77 years, while in group B it was 38±3.12 years. Gender distribution between two groups was analyzed. In Group A 72.3% were males and 27.7 % females while in Group B patients, 70% were males and 30% were females. Mean duration from injury to surgery was 5 days with SD±2.12 in group A, while 5.5±2.37 days in Group B. Analysis of PSI among both groups shows that Group B, in whom Schanz pins technique was used, had significantly high rates of pin site infection (24.1%) compared to group A (9.6%) in whom K-wires technique was used (p 0.012). Conclusion: Our study concludes that the frequency of pin site infection is significantly less in Ilizarov fixator using K-wires (9.6%) as compared to Ilizarov fixator using Schanz pins(24.1%).

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Reducing the incidence of pin site infection in hand surgery with the use of a protocol from Ilizarov

Cited by 7 publications

References 12 publications

Treatment of distal radius fractures using a cemented K-wire frame

Treatment of distal radius fractures using a cemented K-wire frame

What’s New in Hand and Wrist Surgery

Comparison of Pin Site Infection Rate between Schanz Screws and K-Wires in Ilizarov Fixator for Tibial Fracture

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