scholarly journals Kirschner Wire Breakage during Removal Requiring Retrieval

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Kai Yuen Wong ◽  
Rosalind Mole ◽  
Patrick Gillespie
Keyword(s):  
Hand Function ◽  
Kirschner Wire ◽  
Cost Effective ◽  
Middle Finger ◽  
Complication Rates ◽  
Simple Method ◽  
Wire Breakage ◽  
Wire Fixation ◽  
Pin Site ◽  
K Wires

Kirschner wires (K-wires) are widely used for fixation of fractures and dislocations in the hand as they are readily available, reliable, and cost-effective. Complication rates of up to 18% have been reported. However, K-wire breakage during removal is rare. We present one such case illustrating a simple technique for retrieval. A 35-year-old male presented with a distal phalanx fracture of his right middle finger. This open fracture was treated with K-wire fixation. Postoperatively, he developed a pin site infection with associated finger swelling. The K-wire broke during removal with the proximal piece completely retained in his middle phalanx. To minimise risk of osteomyelitis, the K-wire was removed with a novel surgical technique. He had full return of hand function. Intraoperative K-wire breakage has a reported rate of 0.1%. In our case, there was no obvious cause of breakage and the patient denied postoperative trauma. On the other hand, pin site infections are much more common with reported rates of up to 7% in the hand or wrist. K-wire fixation is a simple method for bony stabilisation but can be a demanding procedure with complications often overlooked. It is important to be aware of the potential sequelae.

Staged Management of Severely Displaced Calcaneal Fractures With Transarticular Pinning: A Damage Control Strategy

2021 ◽  
pp. 107110072110130
Author(s):  
Kyeong-Hyeon Park ◽  
Chang-Wug Oh ◽  
Joon-Woo Kim ◽  
Hee-June Kim ◽  
Dong-Hyun Kim ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Internal Fixation ◽  
Kirschner Wire ◽  
Wound Complications ◽  
Calcaneal Fractures ◽  
Simple Method ◽  
Wire Fixation ◽  
The Mean ◽  
Radiographic Union

Background: Severely displaced calcaneal fractures can result in considerable morphology derangement and may be accompanied by soft tissue compromise. Delayed operative restoration of the calcaneal morphology may result in acute retensioning of the damaged soft tissue with associated wound-related complications. In this study, we describe a staged treatment of displaced intra-articular calcaneal fractures that uses temporary transarticular Kirschner wire (K-wire) fixation and staged conversion to definite fixation. Methods: We identified all of the patients who were treated at our institution for calcaneal fractures between 2015 and 2019. A total of 17 patients with 20 calcaneal fractures were selectively treated with 2-stage management. Temporary transarticular K-wire fixation was performed 24 hours after the injury to restore calcaneal morphology and the surrounding soft tissue. After the soft tissue was considered safe, delayed open reduction and internal fixation was performed. The time to definite surgery, radiographic alignment, wound complications, time to radiographic union, and hindfoot American Orthopaedic Foot & Ankle Society (AOFAS) scores were recorded. Results: The average follow-up period was 17 months (range, 12-43). The average Böhler angle increased from a mean of −22 degrees (range, −109 to 25) to 25 degrees (range, 0 to 47) after temporary transarticular K-wire fixation. The mean time from temporary pinning to conversion to definite internal fixation was 20 (range, 10-32) days. There were no immediate postoperative complications. The average time to radiographic union was 13.7 (range, 10-16) weeks. The mean AOFAS score was 87 (range, 55-100). No infections or wound complications were reported during the follow-up period. Conclusion: Temporary transarticular pinning for staged calcaneal fracture treatment is safe and effective in restoring the calcaneal morphology. This novel and relatively simple method may facilitate delayed operation and decrease wound-related complications. Level of Evidence: Level IV, retrospective case series.

Kirschner wire fixation for scaphoid fractures: an experimental study in synthetic bones

2011 ◽  
Vol 36 (4) ◽  
pp. 325-328 ◽  
Author(s):  
V. Gokce ◽  
H. Oflaz ◽  
A. Dulgeroglu ◽  
A. Bora ◽  
I. Gunal
Keyword(s):  
Experimental Study ◽  
Kirschner Wire ◽  
Fracture Pattern ◽  
Biomechanical Stability ◽  
Scaphoid Fractures ◽  
Fracture Patterns ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
K Wires

We have studied the biomechanical stability in vitro of three different Kirschner (K) wire configurations in three types of simulated scaphoid waist fractures. The fractures were created with a saw in Sawbones models. There were three fracture patterns: perpendicular to the long axis of the scaphoid model; and 30° and 20° oblique to that. Two 1.2 mm. K-wires were used in each scaphoid. The three configurations were: parallel; 20° oblique; and crossing. The oblique or crossing configurations of K-wires were the most stable depending on the fracture pattern.

Non-Union in a Fracture of the Shaft of the Distal Phalanx

HAND ◽  
1982 ◽  
Vol os-14 (1) ◽  
pp. 85-88 ◽  
Author(s):  
L. Read
Keyword(s):  
Open Reduction ◽  
Kirschner Wire ◽  
Middle Finger ◽  
Distal Phalanx ◽  
Non Union ◽  
Shaft Fractures ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Type Of Fracture

Fracture of the shaft of the distal phalanx is less common than more distal fractures involving the tuft: non-union in such a fracture is even more unusual. A case is described in which troublesome non-union of the shaft of the distal phalanx of the middle finger was successfully treated by open reduction and Kirschner wire fixation. The type of fracture and its treatment is discussed: it is emphasised that the principles applied to shaft fractures of the middle and proximal phalanges also apply to the distal phalanx.

Lateral condylar fractures of the humerus in children

2018 ◽  
Vol 100-B (3) ◽  
pp. 387-395 ◽  
Author(s):  
R. Ganeshalingam ◽  
A. Donnan ◽  
O. Evans ◽  
M. Hoq ◽  
M. Camp ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Screw Fixation ◽  
Kirschner Wire ◽  
Lateral Condyle ◽  
Fractures In Children ◽  
Wire Fixation ◽  
Long Term Follow Up ◽  
Carrying Angle ◽  
K Wires ◽  
Condylar Fractures

Aims Displaced fractures of the lateral condyle of the humerus are frequently managed surgically with the aim of avoiding nonunion, malunion, disturbances of growth and later arthritis. The ideal method of fixation is however not known, and treatment varies between surgeons and hospitals. The aim of this study was to compare the outcome of two well-established forms of surgical treatment, Kirschner wire (K-wire) and screw fixation. Patients and Methods A retrospective cohort study of children who underwent surgical treatment for a fracture of the lateral condyle of the humerus between January 2005 and December 2014 at two centres was undertaken. Pre, intraoperative and postoperative characteristics were evaluated. A total of 336 children were included in the study. Their mean age at the time of injury was 5.8 years (0 to 15) with a male:female patient ratio of 3:2. A total of 243 (72%) had a Milch II fracture and the fracture was displaced by > 2 mm in 228 (68%). In all, 235 patients underwent K-wire fixation and 101 had screw fixation. Results There was a higher rate of nonunion with K-wire fixation (p = 0.02). There was no difference in Baumann’s angle, carrying angle or the rate of major complications between the two groups. No benefit was obtained by immobilizing the elbow for more than four weeks in either group. No short-term complications were seen when fixation crossed the lateral ossific nucleus. Conclusions Fixation of lateral condylar humeral fractures in children using either K-wires or screws gives satisfactory results. Proponents of both techniques may find justification of their methods in our data, but prospective, randomized trials with long-term follow-up are required to confirm the findings, which suggest a higher rate of nonunion with K-wire fixation. Cite this article: Bone Joint J 2018;100-B:387–95.

scholarly journals Retrospective analysis of Intramedullary K-Wire fixation of Metacarpal Fractures

2021 ◽  
Vol 7 (2) ◽  
pp. 22-27
Author(s):  
Dr. Sunil Kumar Kirar ◽  
◽  
Dr. Sanjay Upadhyay ◽  
Dr. Sanat Singh ◽  
Dr. Atul Varshney ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Kirschner Wire ◽  
Functional Results ◽  
Clinical Results ◽  
Metacarpal Fractures ◽  
Kirschner Wire Fixation ◽  
Metacarpal Bones ◽  
Flexion Extension ◽  
Wire Fixation ◽  
K Wires

Introduction: The majority of fractures of the metacarpal bones occur at a young age.Most of thetimes these metacarpal fractures can be treated conservatively in a POP slab(cock up slab)producing good functional results.Surgery was indicated in patients with palmar dislocation of >30°and shortening of >5 mm.Our study aimed to evaluate the clinical results of all metacarpal fracturestreated surgically by intramedullary Kirschner-wire fixation presented in our hospital.Materials andMethods: It was a retrospective study in which we included 50 patients with metacarpalfractures(both open andclosed) that came in our hospital, treated surgically by closed reduction andwere fixed with two intramedullary k-wires. Result: K-wires were removed after 4 weekspostoperatively,under local anaesthesia in the OPD. Metacarpal joint functions (flexion, extension,rotation) were clinically followed up in all patients, on the median periodof6 months (3 months to 9months). In our study, we found in all patients,flexion and extension were normal on bothsides.Conclusion: Closed reduction and intramedullary k-wire fixation of metacarpal bone fracturesproduce good functional results in the longterm. We found a very low rate of complication and thusrecommendthis surgical method for the stabilization of all these types of fractures.

scholarly journals Biomechanical comparison of bi- and tricortical k-wire fixation in tension band wiring osteosynthesis

2019 ◽  
Vol 24 (1) ◽  
Author(s):  
J. Nowotny ◽  
F. Bischoff ◽  
T. Ahlfeld ◽  
J. Goronzy ◽  
E. Tille ◽  
...  
Keyword(s):  
Cost Effective ◽  
Tension Band ◽  
Tension Band Wiring ◽  
High Rate ◽  
Failure Behavior ◽  
Pullout Strength ◽  
Wire Fixation ◽  
Group 2 ◽  
K Wires ◽  
Biomechanical Comparison

Abstract Background Patients with a simple transversal fracture of the olecranon are often treated with a tension band wiring (TBW), because it is known as a biomechanically appropriate and cost-effective procedure. Nevertheless, the technique is in detail more challenging than thought, resulting in a considerable high rate of implant-related complications like k-wire loosening and soft tissue irritation. In the literature, a distinction is generally only made between transcortical (bi-) and intramedullary (mono-) fixation of the wires. There is the additional possibility to fix the proximal bent end of k-wire in the cortex of the bone and thus create a tricortical fixation. The present study investigates the effectiveness of bi- and tricortical k-wire fixation in a biomechanical approach. Methods TBW of the olecranon was performed at 10 cadaver ulnas from six donors in a usual manner and divided into two groups: In group 1, the k-wire was inserted by bicortical fixation (BC), and in group 2, a tricortical fixation (TC) was chosen. Failure behavior and maximum pullout strength were assessed and evaluated by using a Zwick machine. The statistical evaluation was descriptive and with a paired t test for the evaluation of significances between the two techniques. Results The average age of the used donors was 81.5 ± 11.5 (62–92) years. Three donors were female, and three were male. Ten k-wires were examined in BC group and 10 in the TC group. The mean bone density of the used proximal ulnas was on average 579 ± 186 (336–899) HU. The maximum pullout strength was 263 ± 106 (125–429) N in the BC group and increased significantly in the TC group to 325 ± 102 (144–466) N [p = .005]. Conclusion This study confirms for the first time biomechanical superiority of tricortical k-wire fixation in the olecranon when using a TBW and may justify the clinical use of this method.

Kirschner Wire Breakage after Surgery of the Lesser Toes

1995 ◽  
Vol 16 (8) ◽  
pp. 504-509 ◽  
Author(s):  
Christopher Zingas ◽  
David A. Katcherian ◽  
Kent K. Wu
Keyword(s):  
Rheumatoid Arthritis ◽  
Kirschner Wire ◽  
Metatarsal Head ◽  
Wire Breakage ◽  
Point Of Entry ◽  
Forefoot Surgery ◽  
Postoperative Symptoms ◽  
K Wires ◽  
Rate Of Failure

A retrospective review was made of all patients operated on by the two senior authors from January 1985 to January 1993 for problems with Kirschner wire breakage following forefoot surgery. Thirty-three broken K-wires in 27 patients were encountered. All of these were 0.045-inch K-wires that had been placed across the metatarsophalangeal (MTP) joint of the lesser toes. In no case was there breakage of a K-wire that was larger than 0.045 inches or that did not cross the MTP joint. The medical records and radiographs of 565 consecutive patients having fixation with 0.045-inch K-wires that crossed the MTP joints of the lesser toes were then reviewed. A total of 1002 K-wires were used with an overall failure rate of 3.2% (4.8% of the patients). All of these K-wires failed just proximal to the point of entry into the metatarsal head. No intra-articular retained fragments were noted. Twenty-five of the retained fragments were completely within the metatarsal head and shaft, and eight of these fragments pierced the cortex of the metatarsal proximally. Twenty-three patients with retained fragments were examined in follow-up and in no case could the retained fragment be palpated or directly related to postoperative symptoms. Of the three patients who complained of persistent pain, two had mild pain with persistent MTP synovitis and one had severe pain due to lateral deviation of the toe after surgery. Patients with rheumatoid arthritis who underwent metatarsal head excision were noted to have a higher rate of failure (10.3% of patients, 4.0% of K-wires) than those without rheumatoid arthritis or metatarsal head excision (3.3% of patients, 2.3% of K-wires). Also four of the six cases with multiple K-wire breakage in the same foot had rheumatoid arthritis.

scholarly journals Operative treatment of metacarpal and phalangeal fractures with Kirschner wire fixation: A review

2013 ◽  
Vol 60 (2) ◽  
pp. 49-52 ◽  
Author(s):  
Tomislav Palibrk ◽  
Aleksandar Lesic ◽  
Sladjana Andjelkovic ◽  
Ivan Milosevic ◽  
Rodoljub Stefanovic ◽  
...  
Keyword(s):  
Hand Function ◽  
Operative Procedure ◽  
Kirschner Wire ◽  
Early Mobilization ◽  
Kirschner Wire Fixation ◽  
Hand Fractures ◽  
Wire Fixation ◽  
Hand Fracture ◽  
Excellent Functional Result ◽  
Phalangeal Fractures

Although hand fractures are most common fractures treated in orthopedic practice, many practicians treat them as trivial injuries. Improperly managed they can cause consequences and impair hand function. Metacarpal and phalangeal fractures are classified based on geometry, anatomic localization and wound presence and treatment depend on mechanism of injury. Many of them can be treated nonoperatively with reposition and immobilization, but in some cases osteosynthesis is a method of choice. Surgeon can choose various range of fixation material, and choice depends on fracture type and surgeons affinity. Kirschner wire fixation is one of the most frequently used operative procedure for hand fracture treatment. It provides good stability, early mobilization and excellent functional result.

The Thermal Effects of Kirschner Wire Fixation on Small Bones

1999 ◽  
Vol 24 (3) ◽  
pp. 355-357 ◽  
Author(s):  
A. KHANNA ◽  
S. J. PLESSAS ◽  
P. BARRETT ◽  
L. C. BAINBRIDGE
Keyword(s):  
Lower Limb ◽  
Thermal Effects ◽  
Kirschner Wire ◽  
Point Configurations ◽  
Metatarsal Bones ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Different Types ◽  
Small Bones ◽  
K Wires

The aim of this study was to assess bone heating caused by the passage of fine (<2 mm) K-wires of different types. Stainless steel K-wires of trocar and diamond point configurations (0.8–2.0 mm) were drilled into the metatarsal bones from a freshly amputated lower limb at a constant force. Temperature measurements were made by miniature thermocouples inserted into the bones, at 3 second intervals over a period of 3 minutes while each K-wire was drilled three times. The temperature reached varied with the tip configurations and the diameter of the K-wires. Regardless of point configuration, thinner wires generated more heat than thicker ones.

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