Broken bones can be fixed by surgery using metal pins, screws, nails, rods, or plates. These metal pieces hold the bones in place while they heal. Sometimes, the metal pins need to stick out of your skin to hold the broken bone in place.

The metal and the skin around the pin must stay clean to prevent infection. Sometimes, your surgeon may want you to have these metal pins for months to allow the fracture to heal.

Broken bone - rod care; Broken bone - nail care; Broken bone - screw care

In this article, any metal piece that is sticking out of your skin after surgery is called a pin. The area where the pin comes out of your skin is called the pin site. This area includes the pin and the skin around it.

You must keep the pin site clean to prevent infection. If the site becomes infected, the pin may need to be removed. This could delay bone healing, and the infection could make you very sick.

Check your pin site every day for signs of infection, such as:

• Skin redness
• Skin at the site is warmer
• Swelling or hardening of the skin
• Increased pain at the pin site
• Drainage that is yellow, green, thick, or smelly
• Fever
• Numbness or tingling at the pin site
• Movement or looseness of the pin

If you think you have an infection, contact your surgeon right away.

There are different types of pin-cleaning solutions. The two most common solutions are:

• Sterile water
• A mixture of half normal saline (salt water) and half hydrogen peroxide

Use the solution that your surgeon recommends.

Supplies you will need to clean your pin site include:

• Gloves
• Sterile cup
• Sterile cotton swabs (about 3 swabs for each pin)
• Sterile gauze
• Cleaning solution

Clean your pin site twice a day. Do not put lotion or cream on the area unless your surgeon tells you it is OK.

Your surgeon may have special instructions for cleaning your pin site. But the basic steps are as follows:

• Wash and dry your hands.
• Put on gloves.
• Pour the cleaning solution into a cup and put half of the swabs in the cup to moisten the cotton ends.
• Use a clean swab for each pin site. Start at the pin site and clean your skin by moving the swab away from the pin. Move the swab in a circle around the pin, then make the circles around the pin larger as you move away from the pin site.
• Remove any dried drainage and debris from your skin with the swab.
• Use a new swab or gauze to clean the pin. Start at the pin site and move up the pin, away from your skin.
• When you are done cleaning, use a dry swab or gauze in the same way to dry the area.

For a few days after your surgery, you may wrap your pin site in dry sterile gauze while it heals. After this time, leave the pin site open to air.

If you have an external fixator (a steel bar that may be used for fractures of long bones), clean it with gauze and cotton swabs dipped in your cleaning solution every day.

Most people who have pins can take a shower 10 days after surgery. Ask your surgeon how soon and whether you are allowed to do it.

Green SA, Gordon W. Principles and complications of external skeletal fixation. In: Browner BD, Jupiter JB, Krettek C, Anderson PA, eds. Skeletal Trauma: Basic Science, Management, and Reconstruction. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 8.

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Kazmers NH, Fragomen AT, Rozbruch SR. Prevention of pin site infection in external fixation: a review of the literature. Strategies Trauma Limb Reconstr. 2016;11(2):75-85. PMID: 27174086 pubmed.ncbi.nlm.nih.gov/27174086/.

Whittle AP. General principles of fracture treatment. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 53.