Pin tract infection after uniplanar external fixation of open fractures at a national, teaching and referral hospital

Abstract

Background: Pin tract infection is the most common complication of external fixation accounting for 43% of complications. The presence of a pin tract infection leads to subsequent pin loosening and fixation failure. It also delays conversion of an external fixator to internal fixation until clearance of the infection is achieved. The incidence of pin tract infections in our setting is not known. This study was aimed at determining the incidence and microbe profile of pin tract infection in patients who have undergone uniplanar external fixation following open fractures at Kenyatta National Hospital.

Methods: Consecutive sampling of patients who had undergone uniplanar external fixation at Kenyatta National Hospital (KNH) was done between September 2016 and December 2016. 73 patients were recruited. Data concerning presence of pin tract infection was collected. Patients with discharging sinuses had a culture and sensitivity done while those with major pin tract infection had immediate x-rays done to rule out radiological changes.

Results: Incidence of pin tract infection was 87.7% (64 of 73 patients). Staphylococcus aureus (30.2%) and coagulase negative staphylococci (16.3%) were the commonest causative organisms.

Conclusion: The incidence of pin tract infection after uniplanar external fixation is high. Better surgical technique and pin-site care is recommended. Staphylococcus aureus is the leading cause of pin site infection.