The effect of HIV infection on the incidence and severity of circular external fixator pin track sepsis: a retrospective comparative study of 229 patients

Pin track sepsis is a common complication of circular external fixation. HIV status has been implicated as an independent risk factor for the development of pin track infection and has been cited as a reason not to attempt complex limb reconstruction in HIV-positive patients. This retrospective review of patients treated with circular external fixators looked at the incidence of pin track sepsis in HIV-positive, HIV-negative and patients whose HIV status was unknown. The records of 229 patients, 40 of whom were HIV-positive, were reviewed. The overall incidence of pin track sepsis was 22.7 %. HIV infection did not affect the incidence of pin track sepsis (p = 0.9). The severity of pin track sepsis was not influenced by HIV status (p = 0.9) or CD4 count (p = 0.2). With the employment of meticulous pin insertion techniques and an effective postoperative pin track care protocol, circular external fixation can be used safely in HIV-positive individuals.