Does pin tract infection after external fixator limits its advantage as a cost-effective solution for open fractures in low-middle income countries, a prospective cohort study

OBJECTIVE: To determine the frequency of pin tract infection in external fixator tibia and its effects on the definite fracture fixation and bone healing. METHODS: The prospective study was conducted at Lady Reading Hospital, Peshawar, Pakistan, from August 2017 to July 2018, and comprised patients regardless of age and gender with open fracture tibia Gustillo-Anderson type II and type IIIA. Pin tract infection was assessed following the application of locally made external fixation of tibia open fractures. Follow-up was done fortnightly till soft tissue healing, removal of external fixator and definite fracture healing. Pin tract infection was classifiedand treated according to the Checketts-Otterburn classification system. SPSS 20 was used for data analysis. RESULTS: Of the 117 patients, 95(81%) were males and 22(19%) were females with an overall mean age of 24.7±9.35 years. Pin tract infection was documented in 28(23.9%) patients. Minor and major pin tract infections were reported in 27(96.4%) and 1(3.5%) patient respectively. Soft tissues healed in 27(96.4%) cases. CONCLUSION: External fixator for initial stabilisation of open tibial fractures in all patients is recommende