Osteosynthesis and Trauma Care 2004; 12(2): 85-88
DOI: 10.1055/s-2004-822793
Original Article

© Georg Thieme Verlag Stuttgart · New York

The Control of Pin Tract Colonization with Antibiotic Coated Sleeves: A Prospective Study of External Fixation of Distal Radius Fractures

J. S. Madsen1 , C. S. Roberts1 , D. Seligson1
  • 1Department of Orthopaedics, University of Louisville Hospital, USA
Further Information

Publication History

Publication Date:
05 July 2004 (online)


Objective: The purpose of this study was to assess the efficacy of antibiotic coated pin sleeves to reduce pin site colonization and subsequent infection with external fixation of the distal radius.
Study Design/Methods: A prospective, randomized, investigation of gentamicin coated sleeves for use with external fixation was performed after approval was obtained from the Institutional Review Board (IRB) involving informed consent of 28 patients with distal radius fractures treated with external fixation. Patients were enrolled in the study and randomized into two groups: group one (gentamicin 0.2 to 0.4 mg/cm2 polyether-based, thermoplastic tubing antibiotic coated sleeves covering 3 mm half-pins) and group two (3 mm half-pins without antibiotic coated sleeves). All other fixateur configurations and treatments were the same. Prophylactic, perioperative antibiotics were administered in all cases intravenously. No additional antibiotics were given post-operatively. Clinical follow-up was performed at 2, 4, and 6 weeks, 3 months and 6 months post-operatively. The Fracture Service Attending, the Trauma Fellow, and 2 orthopaedic residents were responsible for the placement of the external fixateur and subsequent follow-up in the orthopaedic clinic.
Results: Of the 28 patients enrolled in the study, two patients were disqualified. One patient had antibiotics given in an emergency room visit for unrelated injuries and one patient asked to be withdrawn from the study. Twenty-six patients completed the study. Thirty-eight percent (10/26) were randomly fitted with antibiotic coated sleeves and sixty-one percent (16/26) did not have antibiotic coated sleeves. In the 10 patients with antibiotic sleeves, 42 total pins were used. The pins were sent for lab culture when the external fixateur was removed. Twenty-nine percent (12/42) of the half-pins cultured positive with 4/12 (33 %) positive for yeast and 8/12 (66 %) positive for S. epidermis. Of the 16 patients that did not receive the antibiotic coated sleeves, 34 of the 64 (53 %) total pins used were cultured positive for infection. Sixty-eight (23/34) were positive for S. aureus, 8/34 (24 %) were positive for S. epidermis, and 3/34 (8 %) were positive for S. intermedius. There were no late infections at the three and six month follow-up appointment. These differences were significant because S. aureus and S. intermedius were only cultured on the pins without antibiotic sleeves.
Conclusion: Antibiotic coated sleeves placed over half-pins used in external fixation of fractures are efficacious in reducing the incidence of pin tract colonization and in changing the spectrum of organisms recovered to less virulent organisms.


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David SeligsonMD, Professor 

Department of Orthopaedics · University of Louisville Hospital

ACB Bldg., 3rd Floor Bridge

550 S. Jackson Street

Louisville, KY 40202


Phone: +1/5 02-8 52-09 23

Fax: +1/5 02-8 52-89 51

Email: seligson@louisville.edu

Email: josh.madsen@louisville.edu