Life- and limb-threatening infections following the use of an external fixator

The Bone & Joint Journal
J J JaureguiJ E Herzenberg

Abstract

External fixation is widely used in orthopaedic and trauma surgery. Infections around pin or wire sites, which are usually localised, non-invasive, and are easily managed, are common. Occasionally, more serious invasive complications such as necrotising fasciitis (NF) and toxic shock syndrome (TSS) may occur. We retrospectively reviewed all patients who underwent external fixation between 1997 and 2012 in our limb lengthening and reconstruction programme. A total of eight patients (seven female and one male) with a mean age of 20 years (5 to 45) in which pin/wire track infections became limb- or life-threatening were identified. Of these, four were due to TSS and four to NF. Their management is described. A satisfactory outcome was obtained with early diagnosis and aggressive medical and surgical treatment. Clinicians caring for patients who have external fixation and in whom infection has developed should be aware of the possibility of these more serious complications. Early diagnosis and aggressive treatment are required in order to obtain a satisfactory outcome.

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Citations

Sep 4, 2015·The Bone & Joint Journal·J Parvizi, F S Haddad
Aug 19, 2016·The Journal of Bone and Joint Surgery. American Volume·Reggie C HamdyS Robert Rozbruch
Nov 16, 2018·The Journal of the American Academy of Orthopaedic Surgeons·Adam LeeWilliam T Obremskey
Apr 13, 2019·BMC Infectious Diseases·Arne SchröderChristina Oetzmann von Sochaczewski
Apr 26, 2017·Strategies in Trauma and Limb Reconstruction·Julian FürmetzPeter H Thaller
Mar 16, 2021·Journal of Clinical Orthopaedics and Trauma·Hady H EltayebyJohn E Herzenberg
Apr 9, 2019·Injury·A H R W SimpsonS T J Tsang
Jun 5, 2021·Journal of Bone and Joint Infection·Mats BueJuozas Petruskevicius

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