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Is the proximity of external fixator pins to eventual definitive fixation implants related to the risk of deep infection in the staged management of tibial pilon fractures?

Injury Sep 18, 2019

Potter JM, et al. - Researchers investigated the influence of overlap or proximity of definitive internal fixation to external fixation pin sites on the risk of deep infection. From two level-one trauma centers, they assessed data of 280 AO/OTA 43B or 43C type distal tibia fractures in 277 patients. Staged management using early temporizing external fixation followed by definitive open reduction and plate fixation was undertaken in the patients. Outcomes revealed that overlap of the definitive construct with pin sites is not associated with the risk of deep infection. They recommend not compromising construct length for the sake of avoiding pin site overlap and suggest placing temporizing external fixation pins for obtaining optimal stability of the construct with a lesser emphasis on aiming to be absolutely outside the zone of future fixation.
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