The Half-Pin and the Pin Tract: A Survey of the Limb Lengthening and Reconstruction Society

Although the key principles of external fixation have changed little over the years, there remains a significant amount of variation in fixation methods and postoperative care. In particular, use and management of half-pins intended for prolonged reconstruction are the subject of strong opinions and intense debate.

We conducted a study of common trends in use and management of half-pins and in treatment of pin-tract infections in circular fixation by polling subject matter experts who are members of the Limb Lengthening and Reconstruction Society.

Although the distribution of stainless steel half-pins (52%) and titanium half-pins (48%) was similar, most respondents preferred hydroxyapatite coating (81%). Respondents commonly encouraged use of a shower (60%) and a washing solution (67%) for pin-site care. For pin-tract infections, oral antibiotics were prescribed more often (83%) than parenteral antibiotics (17%) and were given for 8 days on average.

Results from this study helped identify trends in application techniques and in routine management of circular fixators. In addition, they helped identify several areas of clinical equipoise that should be studied, including metallurgy, pin-site care solutions, and antibiotics.