Predictive factors for pin sites infection in external fixation of open tibia fractures

Abstract

Objectives: External fixation is a readily available fixation method for some open tibia fracture grades. Pin site infection (PSI) is a common complication that leads to pin loosening and osteomyelitis. Understanding the predictive factor for PSI can reduce the incidence. This study aimed to determine the predictive factors for PSI in the external fixation of open tibia fractures. Methods: This was a prospective observational study. The biodemographic variables of the patient collected were age, sex, marital status, mechanism of injury, body mass index, number of pins inserted, pre-operative hematocrit, comorbidity, duration of the hospital stay, Gustilo/Andersen grades of open tibia fractures, and bacterial isolates among those with PSI. Results: Thirty patients who met the inclusion criteria were included in the study with a mean age of 45.9 years ± 17.7 with a male-to-female ratio of 3.3:1. Motor vehicle accidents and motorcycle/motor vehicle accidents were the predominant cause of injury in 56.7% of the patients. The incidence of PSI was 36.7%, with Staphylococcus aureus being the most common bacterial isolated at 81.8%. Only grades of open tibia fractures are the predictive factor for PSI (adjusted odds ratio 18.33, 95% confidence interval of 1.609–208.864, P = 0.019). Conclusion: The predictive factor that was statistically significantly associated with PSI in this study was the grades of the open tibia fractures.