Pin-site infection remains a significant problem for patients treated by external fixation. A randomized trial was undertaken to compare the weekly use of alcoholic chlorhexidine (CHX) for pin-site care with an emollient skin preparation in patients with a tibial fracture treated with a circular frame. Patients were randomized to use either 0.5% CHX or Dermol (DML) 500 emollient pin-site care. A skin biopsy was taken from the tibia during surgery to measure the dermal and epidermal thickness and capillary, macrophage, and T-cell counts per high-powered field. The pH and hydration of the skin were measured preoperatively, at follow-up, and if pin-site infection occurred. Pin-site infection was defined using a validated clinical system.Aims
Methods
Fracture and deformity after frame removal is a known risk in 9–14.5% of patients after circular frame treatment. The aims of this study were to assess the effectiveness of our staged protocol for frame removal and risk factors for the protocol failure. We identified 299 consecutive patients who underwent circular frame fixation for fracture or deformity correction in our unit from our prospective database. All 247 patients who followed the staged frame removal protocol were included in this study. We reviewed the electronic clinical record and radiographs of each patient to record demographics, risk factors for treatment failure and outcome following frame removal. We defined failure of the protocol as a re-fracture or change in bony alignment within 12 weeks of frame removal. Results underwent statistical analysis using Chi square analysis.Introduction
Methods and materials