Kirschner wire pin site infection in hand and wrist fractures: incidence rate and risk factors.

Kirschner wires are widely used for skeletal fixation of unstable fractures, but the pin tracks create a potential pathway through the skin and into the bone for bacteria to cause an infection. We tested the null hypothesis that there are no demographic, patient-related, injury, or treatment variables independently associated with the occurrence of pin site infection after percutaneous fixation of hand and wrist fractures using Kirschner wires. A retrospective review of 1213 patients with one or more fractures of the hand and wrist treated with percutaneous Kirschner wire fixation identified 85 patients (7%) who had additional treatment with oral antibiotics, early pin removal, or reoperation related to a pin site infection. We found no factors were independently associated with higher or lower risks of pin site infection in multivariable logistic regression analysis. Pin site infections - most benign - occur in a notable number of patients and we could not identify any modifiable risk factors. LEVEL OF EVIDENCE: III.