Today's News

Saturday, February 24, 1996

Auxiliary pins improve performance of external fixators

Placement of an auxiliary pin in external fixators can minimize complications in treating femoral shaft fractures in children under the age of six years, according to a study presented today in scientific exhibit 42.

Thirty-six children between the ages of six and 18 years with 38 femur fractures were treated with external fixators. Twenty-two of the fixators had the standard two or three pins above and below the fracture. The remaining 16 patients had an auxiliary pin inserted close to the fracture site and secured to the body of the fixator with a composite of 16-gauge wire and methyl methacrylate. All of the fixators were dynamized, with 22 of the 38 fully dynamized for at least 30 days prior to their removal which minimizes the rate of refracture.

According to the study compiled by James B. Sola, MD, orthopaedic resident at Washington University in St. Louis, seven of the 22 fractures treated without an auxiliary pin lost reduction. Six of the fractures required remanipulation and one had a malunion.

"We feel that the placement of an auxiliary pin significantly increases the stability of the fixation and decreases the frequency of loss of reduction," said Dr. Sola.

Thirty-one patients were followed for at least one year after their injuries. There were no nonunions; 18 femurs developed superficial pin tract infections requiring antibiotics - however no patient developed a deep infection or osteotomyelitis.

Orthopaedic surgeons who co-authored the study with Dr. Sola are J. Eric Gordon, MD; Perry L. Schoenecker, MD; William B. Strecker, MD; and Eliana D. Delgado, MD, all of the department of orthopaedics, Washington University Medical Center, St. Louis.

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