Deep Bone Abscess After Pin Tract Infection of an Operatively Treated Supracondylar Humeral Fracture

TL;DR

This paper presents a rare case of a deep bone abscess following a pin tract infection in a child with a humeral fracture, emphasizing the need for early detection and proper treatment.

Contribution

The paper reports a unique clinical case highlighting the progression of a pin tract infection to a deep bone abscess and its management.

Findings

A pin tract infection can progress to a deep bone abscess if not adequately treated.

Surgical debridement and intravenous antibiotics led to a satisfactory outcome in this case.

Early detection and microbiology-guided therapy are critical for managing such rare complications.

Abstract

Deep bone abscesses are a rare complication following a pin tract infection. This article shows the importance of early detection, surgical management, and microbiology-guided antibiotic therapy to treat the abscess. We aim to highlight the key presenting factors, the radiological signs, and intraoperative features of a deep bone abscess, to facilitate detection in these rare circumstances.

Closed or open reduction and internal fixation with Kirschner wires (K-wires) has become the standard of care for displaced supracondylar fractures. Although pin tract infection (PTI) is the most common complication of K-wire fixation, deep bone abscess following this infection is rare. We are reporting a unique case in which a pin tract infection developed into a deep bone abscess.

An eight-year-old female patient presented with a right supracondylar fracture of the humerus. The fracture was managed with closed reduction and K-wire fixation. This case was complicated by a PTI, which was initially managed with wire removal and oral antibiotics. The infection developed into a deep bone abscess, which required operative incision and drainage, debridement, and intravenous antibiotics.

Septic arthritis, osteomyelitis, and late deep infections are rare complications of pin tract infection, but surgeons must consider them to allow for prompt diagnosis and adequate treatment. Satisfactory long-term outcome of these deep infections can be expected when treated with surgical debridement and intravenous antibiotics.

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