Septic arthritis of the major joints of the lower limb after periarticular external fixation application: are conventional safe corridors enough to prevent it?

Abstract

Septic arthritis as a result of pin track infection, following application of external fixators in periarticular fractures of the lower limb, is a rare, but serious complication. Several studies, combining cadaver dissection and MRI scans or conventional X-ray measurements, have tried to define the exact anatomy of the capsular reflection in the major joints of the lower limb (hip, knee and ankle), in order to provide specific safe corridors for extra-capsular wire and pin placement. These studies are reviewed, their methods and results are presented, and their conclusions are evaluated as suggested guidelines for safe extra-capsular wire and pin insertion.