|
Back to 2017 Scientific Program ePosters
Betadine Soaked Alcohol Pad: A Cheap and Effective Method to Diminish Pin Site Complications in Hand Fractures
Isaiah Levy, BS; Aakash Keswani, BA; Andrew J Lovy, MD, MS; Michael R. Hausman, MD
Mount Sinai School of Medicine, New York, NY
Purpose: Kirschner wire (K-wire) fixation is frequently utilized in the management of unstable hand fractures. Buried versus percutaneous K-wire positioning remains debated due to concerns of pin site infection and ease of hardware removal. Pin site infection rates have been described in as many as 34% of patients; however no standardized protocol for pin care has been established. We describe a cheap and effective method of pin care utilizing a betadine soaked alcohol pad that minimizes risk of pin site complications. The purpose of this study was to assess the rate of pin site infection among patients treated for metacarpal and phalangeal fractures with percutaneous K-wires utilizing our standardized pin care protocol.
Methods: We conducted a retrospective review from 2010-2016 of all patients that underwent percutaneous pinning for metacarpal or phalangeal fractures. All pins were trimmed external to the skin and covered with a betadine soaked alcohol pad. Primary clinical outcomes of interest were hardware complications, reoperation rates, and infection complications. Infection was assessed using the Modified Oppenheim Classification criterion. Patient characteristics (age, gender), fracture data (type, closed vs. open), and peri-procedural variables (number of pins, date pins removed, follow-up) were collected and analyzed.
Results: A total of 161 patients were identified, of which 58 (36%) patients with 81 K wires had adequate data collection and follow-up to be included for analysis. Our cohort included 24 metacarpal (MC) and 34 phalangeal (PL) fractures of which 6 were open (1 MC, 5 PL). There were no pin site infections with the use of betadine soaked alcohol pads. The average pin-removal times for MC and PL K-wires were 4.2 and 4.6 weeks, with an average follow-up of 15.6 and 23.1 weeks, respectively. Overall 1 patient (1.7%) suffered a complication which was due to a flexure contracture. An average of 1.4 K-wires was used per case (1.3 for MC, 1.5 for PL). No pins were removed early. There was no difference in complications based on fracture type, time to pin removal, open vs. closed fracture, or the number of K-wires used. Within each of the MC and PL cohorts, there was also no relationship between patient characteristics, fracture data, and all peri-procedural variables.
Conclusion: Betadine soaked alcohol pads are a cheap and effective method of limiting pin site complications in the treatment of hand fractures. Percutaneous K-wire fixation remains an effective method of hand fracture fixation with a low complication rate.
Back to 2017 Scientific Program ePosters
|
