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Background: Pin site infection is a common complication with external fixation, with a reported incidence of 26%-71% in the context of limb reconstruction. The Checketts and Otterburn (C&O) classification is frequently used, with minor infections (C&O I-III) treated with pin site care and enteral antibiotics. Major infections (C&O IV-VI) require removal of the infected pin or fine wire. Surgical debridement is indicated where the infection persists following pin removal (C&O grade VI). The Versajet hydrosurgery system (Smith & Nephew, Memphis, Tennessee) utilizes a saline jet to debride biological tissue. Methods: A retrospective review was conducted on all patients who underwent Versajet hydrosurgery debridement with C&O grade VI pin site infections between January 2011 and January 2021. Data regarding patient demographics, fixator type, indication for the initial surgery, and treatment outcome were recorded. Results: The cohort comprised seven males (87.5%) and one female (12.5%) with a mean age of 41.4 years ± 17.74 (range 16-61). Mean follow-up was 11.8 months ± 6.2 (range 7-25). The mean time in external fixator was 155 days ± 85.19 (range 83-354), and the mean time between fixator removal and Versajet debridement was 46 days ± 33.83 (range 3-116). No perioperative complications were experienced, and all patients (n = 8, 100%) were found to be infection-free at the last clinical review, with healed overlying soft tissue. Conclusion: The Versajet hydrosurgical debridement system is effective in managing C&O grade VI pin site infections. The method is reproducible and provides long-term clearance of infection, allowing subsequent soft tissue healing. [ABSTRACT FROM AUTHOR]

Background: The accuracy of hexapod circular external fixator deformity correction is contingent on the precision of radiographic analysis during the planning stage. The aim of this study was to compare the SMART Taylor spatial frame (TSF) in suite radiographic analysis methods with the traditional manual deformity analysis methods in terms of accuracy of correction. Methods: Sawbones models were used to simulate two commonly encountered clinical scenarios. Traditional manual radiographic analysis and digital SMART TSF analysis methods were used to correct the simulated deformities. Results: The final outcomes of all six analysis methods across both simulated scenarios were satisfactory. Any differences in residual deformity between the analysis methods are unlikely to be clinically relevant. All three SMART TSF digital analyses were faster to complete than manual radiographic analyses. Conclusion: With experience and a good understanding of the software, manual radiographic analysis can be extremely accurate and remains the gold standard for deformity analysis. In suite SMART TSF radiographic analysis is fast and precise to within clinically relevant parameters. Surgeons can with confidence trust the SMART TSF software to provide analysis and corrections that are clinically acceptable. [ABSTRACT FROM AUTHOR]