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The authors are from the Department of Orthopaedics and Sports Medicine (CM, RF, CK), Harborview Medical Center, University of Washington, Seattle, Washington; and the Department of Orthopedics (MLR), McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas.
Mr McDonald, Dr Routt, and Dr Kleweno have no relevant financial relationships to disclose. Dr Firoozabadi is a paid consultant for Smith & Nephew.
Unstable pelvic ring fractures are severe injuries that have a high rate of morbidity and mortality. 1-4 The acute use of external fixation of unstable pelvic fractures is an essential treatment tool and has been shown to reduce morbidity and mortality rates to levels seen in stable pelvic fractures. 5-7 In certain instances, the external fixator is used as the definitive treatment or as an adjunct to posterior fixation for the pelvic injury and is kept on the patient for 6 weeks or longer.
One common complication of external fixation is pin-site infection associated with the Schanz pins (DePuy Synthes, Paoli, Pennsylvania). 8-13 Pin-site infection can lead to chronic osteomyelitis, requiring extended courses of antibiotics, surgical debridement, and bone grafting. 14,15 In addition to risks from the infection, pin-site infections complicate patients' recovery by re-introducing instability into the fracture site and delaying mobility and rehabilitation. Little data are available on superficial or deep infection rates after pelvic external fixation. Specifically, no studies have attempted to identify risk factors for developing pin-site infections after pelvic external fixation.
Another potential complication of external fixation specific to the pelvis is damage to the lateral femoral cutaneous nerve (LFCN) during surgery. Data on incidence of long-term damage to the LFCN remain limited. 16
The purposes of this study were to identify the incidence of superficial and deep infections after pelvic external fixation and to examine which risk factors may increase the risk of postoperative pin-site infections. Secondarily, the study aimed to describe the incidence of LFCN injury.
Materials and Methods
This study was approved by the authors' institutional review board. A prospectively collected orthopedic trauma database at the authors' level I trauma center was retrospectively reviewed to identify patients who had undergone pelvic external fixation between January 2010 and December 2014. Included patients had presented with acute traumatic injuries to their pelvis deemed...