Orthopedic External Fixator Pin Stability Assessment Form
Complete this form to document observations and decisions regarding the stability of external fixator pins. Please review each section carefully and provide objective assessments.
Pin Site Location
*
Please Select
Femur
Tibia
Humerus
Radius/Ulna
Pelvis
Other
Number of Pins Assessed
*
Pin Stability (Manual Testing)
*
Stable
Slightly mobile
Clearly mobile
Signs of Pin Loosening
*
None
Mild (early movement, no pain)
Moderate (movement with pain)
Severe (gross movement, instability)
Pin Site Infection Signs
*
Redness
Swelling
Discharge
Tenderness
No infection signs
Pain Level at Pin Site
*
No pain
0
1
2
3
4
5
6
7
8
9
Severe pain
10
0 is No pain, 10 is Severe pain
Pin-Bone Interface Appearance
*
Normal (dry, clean)
Serous discharge
Purulent discharge
Granulation tissue
Follow-up Action Recommended
*
Please Select
Continue observation
Pin site care
Pin tightening/replacement
Consult orthopedic specialist
Overall Pin Stability Rating
*
1
2
3
4
5
Additional Observations or Comments
Submit Assessment
Should be Empty: