Hydroxyapatite-coated pins versus titanium alloy pins in external fixation at the wrist: a controlled cohort study.
J Trauma
; 70(4): 845-51, 2011 Apr.
Article
en En
| MEDLINE
| ID: mdl-20805762
ABSTRACT
BACKGROUND:
The purpose of this study was to analyze whether the prevalence of pin-related complications can be reduced by the use of hydroxyapatite (HA)-coated pins in external fixators applied for unstable wrist fractures.METHODS:
Forty patients (160 pins) were randomized for standard uniplanar fixator treatment with the use of identically designed pins either composed of titanium-alloy (Ti6Al4V) (n = 20) or coated by HA (n = 20). Each pin site was clinically evaluated with regard to erythema, drainage, pain value, and radiologically assessed concerning loosening at T1 (mean, 9 days), T2 (mean, 43 days), and T3 (mean, 56 days). In case of pin-track complication, the patient was followed continuously. The need for antibiotics or additional surgery was documented. Bone mineral density was analyzed by Dual Energy X-ray Absorptiometry. At fixator removal (T2), the pin-extraction strength was measured by the use of a digital-torque-wrench.RESULTS:
Two minor pin-track infections requiring oral antibiotics occurred in the HA-pin group (2.7%) (p > 0.05). The vast majority of clinical pin-site parameters were comparable in both groups. At the end of the fixator therapy, there were 16 loose pins (n(Ti6AL4V-group) = 10; n(HA-group) = 6). The rate of loose pins was correlated to patient's age (p < 0.05) but not to bone mineral density values or the occurrence of pin-site infection. Finally, no significant difference between the two groups was detected with regard to the prevalence of clinical relevant pin-site complications (p = 0.80).CONCLUSIONS:
In external fixation of the wrist, the use of HA-coated pins yields no clinical advantages there is a trend toward a superior pin-bone anchorage, but a tendency of increased susceptibility for minor pin-track infections.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Traumatismos de la Muñeca
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Clavos Ortopédicos
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Durapatita
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Materiales Biocompatibles Revestidos
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Aleaciones
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Fracturas Óseas
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Fijación de Fractura
Tipo de estudio:
Clinical_trials
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Diagnostic_studies
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Etiology_studies
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Observational_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Trauma
Año:
2011
Tipo del documento:
Article
País de afiliación:
Alemania