Fixation strength and pin tract infection of hydroxyapatite-coated tapered pins

In a multicenter, prospective, randomized study, the biomechanical and clinical properties of the bone-pin interface were compared with standard tapered pins and hydroxyapatite-coated tapered pins implanted in patients who underwent femoral and tibial external fixation treatments. The results showed that the hydroxyapatite-coated tapered pins are clinically effective in improving the strength of fixation of the bone-pin interface. This improvement corresponded to a lower rate of pin tract infection. In the hydroxyapatite-coated pin group, there were no differences in strength of fixation between the pins removed from the infected and uninfected pin tracts. In this pin group, the mean pin extraction torque was 531 ± 225 Ncm in the infected pin tracts and 508 ± 233 Ncm in the uninfected pin tracts. In the standard pin group, the mean pin extraction torque was 73 ± 142 Ncm in the infected pin tracts and 211 ± 216 Ncm in the uninfected pin tracts. The advantages provided by the hydroxyapatite-coated pins were higher in cancellous bone than in cortical bone.