Pin Care for External Fixators

Your child has recently had surgery for the placement of an external fixator device. The external fixator is made of pins, which go through the skin and muscle and into the bone. These pins are then attached to an external bar or frame. The external fixator may be used to hold bones in place while a fracture heals, or they can be used to lengthen or rotate bone.

Patient Instructions:

Daily care

1. You will need to do pin care once every day.

2. First check all pin sites for signs of infection. Signs of infection can include:

   • Pus (thick, creamy drainage) coming from any pin site

   • Redness or tender area around pins

   • Fever of 101.5°F (38.6°C) or higher

   • Bleeding from a pin site that does not stop after applying pressure to the area.

   • If you think that a pin site is infected, call 215-590-1527 on a weekday, or call 215-590-1000 on nights or weekends and ask the operator to page the orthopedic surgeon on call.

3. Next, you will perform the pin care as instructed below. Pin care at home does not need to be sterile.

Pin care

Wash daily with soap and water. Please follow the specific instructions from your orthopedic surgery team.

For pins with crusting:

1. Fill a cup with one tablespoon of tap water and one tablespoon of hydrogen peroxide.

2. Wet cotton swabs with water/hydrogen peroxide mixture.

3. Gently clean skin around the pins. Get a new cotton swab when the old one is dirty. Use a new cotton swab for each pin site.

4. Gently remove crusts as they are loosened.

5. Gently rinse the pin sites with just clean tap water after cleaning with the hydrogen peroxide mixture.

6. If there is drainage around pin site, cover with a piece of gauze. Cut a slit in the gauze square so that it will fit around the pin.

7. Place gauze square around the pin and tape in place.

Bathing

You may take a shower one week after surgery. Ok to wash your arm or leg with fixator with mild soap and water. Sit on edge of tub or on chair in shower. Do not submerge the fixator device under water.

General instructions

• After 2 weeks, the skin around the pin sites should be healed. If you bang the external fixator on something, you may have some bleeding from a pin site. Apply pressure with gauze for a few minutes. This should stop the bleeding. If the bleeding does not stop, call the orthopedic surgical team.

• Wear loose-fitting clothes. Larger size sweatpants work well. Pants with Velcro or snap closures on the sides work best.

Safety

• Never walk on wet floors or areas where your child may slip.

• Wear sturdy sneakers and socks when you are up and moving.

• Be sure you have enough space around you at all times in order to avoid bumping the fixator.

Division of Orthopaedics

Weekdays:

215-590-1527

Nights, weekends and holidays:

Call 215-590-1000 and ask the operator to page the orthopedic resident on call.

Reviewed March 2024 by Meg Morro, RN