A comparative study of four methods in treatment of pin tract infection in children supracondylar humerus fractures

The purpose of this study was to compare prospectively the incidence of pin tract infection in children supracondylar fractures of humerus managed by different frequency of pin care. From April 2004 to February 2014, one hundred and eighty supracondylar humerus fractures in children were randomized to postoperative pin care by no pin tracts cleaning (Group A, 45 cases) or cleaning pin tracts daily (Group B, 45 cases) or cleaning every other day (Group C, 45 cases) or cleaning weekly (Group D, 45 cases). The patient demographics and fracture characteristics of the four groups were comparable. Perioperative care was standardized. The data of pin retention time, union time and the rate of pin tract infection were recorded. The average follow-up time was 5.7 +/- 1.6 months in Group A, 6.0 +/- 1.5 months in Group B and 5.8 +/- 1.4 months in Group C and 6.3 +/- 1.5 months in Group D. There was no significant difference in union time and pin retention time between the four groups. 72 cases (40%) had pin tract infection. Among them, the rate of grade 1 infection occurred about 20% and grade 2 about 11.1% and grade 3 about 5.6%. No significant difference was found between four groups in frequency and severity of pin tract infection (both P>0.05). However, complain of pain was more frequent in Group B than other three groups (P<0.05). Our results indicated that the four methods were effective in treatment of pin tract infection of children supracondylar humerus fractures. However, excessive frequent care caused more fear and anxiety in the mood of children and parents.