Evaluation of outcome of intramedullary K-wire fixation in Phalanx fractures

Abstract Aims The aim of this study was to compare the fixation stability and complications in patients undergoing periacetabular osteotomy (PAO) with either K-wire or screw fixation. Patients and methods We performed a retrospective study to analyze a consecutive series of patients who underwent PAO with either screw or K-wire fixation. Patients who were treated for acetabular retroversion or had previous surgery on the ipsilateral hip joint were excluded. 172 patients (191 hips: 99 K-wire/92 screw fixation) were included. The mean age at the time of PAO was 29.3 years (16–48) in the K-wire group and 27.3 (15–45) in the screw group and 83.9% were female. Clinical parameters including duration of surgery, minor complications (soft tissue irritation and implant migration) and major complications (implant failure and non-union) were evaluated. Radiological parameters including LCE, TA and FHEI were measured preoperatively, postoperatively and at 3-months follow-up. Results Duration of surgery was significantly reduced in the K-wire group with 88.2 min (53–202) compared to the screw group with 119.7 min (50–261) (p < 0.001). Soft tissue irritation occurred significantly more often in the K-wire group (72/99) than in the screw group (36/92) (p < 0.001). No group showed significantly more implant migration than the other. No major complications were observed in either group. Postoperative LCE, TA and FHEI were improved significantly in both groups for all parameters (p = < 0.0001). There was no significant difference for initial or final correction for the respective parameters between the two groups. Furthermore, no significant difference in loss of correction was observed between the two groups for the respective parameters. Conclusion K-wire fixation is a viable and safe option for fragment fixation in PAO with similar stability and complication rates as screw fixation. An advantage of the method is the significantly reduced operative time. A disadvantage is the significantly higher rate of implant-associated soft tissue irritation, necessitating implant removal. Level of evidence III, retrospective trial.

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Motion and Strength Analysis of 2-Tine Staple and K-Wire Fixation in Scapholunate Ligament Stabilization in a Cadaver Model

Journal of Hand Surgery Global Online ◽

10.1016/j.jhsg.2020.12.004 ◽

2021 ◽

Vol 3 (2) ◽

pp. 67-73

Author(s):

Daniel Hess ◽

Anthony Archual ◽

Zachary Burnett ◽

Hans Prakash ◽

Emily Dooley ◽

...

Keyword(s):

Strength Analysis ◽

Scapholunate Ligament ◽

Wire Fixation

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

Foot & Ankle International ◽

10.1177/10711007211013012 ◽

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.

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Suture Button Compared With K-Wire Fixation for Maintenance of Posttrapeziectomy Space Height in a Cadaver Model of Lateral Pinch

The Journal Of Hand Surgery ◽

10.1016/j.jhsa.2010.09.007 ◽

2010 ◽

Vol 35 (12) ◽

pp. 2061-2065 ◽

Cited By ~ 35

Author(s):

Jeffrey Yao ◽

Dan A. Zlotolow ◽

Ryan Murdock ◽

Matthew Christian

Keyword(s):

Suture Button ◽

Wire Fixation

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Correction of Fixed Hammertoe Deformity with Resection of the Head of the Proximal Phalanx and Extensor Tendon Tenodesis

Foot & Ankle International ◽

10.1177/107110079501600714 ◽

1995 ◽

Vol 16 (7) ◽

pp. 449-451 ◽

Cited By ~ 14

Author(s):

Shahan K. Sarrafian

Keyword(s):

Proximal Phalanx ◽

Extensor Tendon ◽

Surgical Correction ◽

Wire Fixation

A method of surgical correction of a fixed hammertoe deformity is presented. It incorporates the resection of the head of the proximal phalanx with an extensor tendon tenodesis to the dorsum of the proximal phalanx. The controlled tension in the extensor tendon provides the necessary stability. It alleviates the use of K-wire fixation.

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Results of small-joint arthrodesis: Comparison of Kirschner wire fixation with tension band wire technique

The Journal Of Hand Surgery ◽

10.1016/0363-5023(92)90476-6 ◽

1992 ◽

Vol 17 (5) ◽

pp. 952-956 ◽

Cited By ~ 28

Author(s):

C.B. Ijsselstein ◽

D.B. van Egmond ◽

S.E.R. Hovius ◽

J.C. van der Meulen

Keyword(s):

Kirschner Wire ◽

Tension Band ◽

Tension Band Wire ◽

Kirschner Wire Fixation ◽

Wire Fixation ◽

Small Joint

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Intraosseous wire fixation versus rigid osseous fixation of mandibular fractures: A preliminary report

Journal of Oral and Maxillofacial Surgery ◽

10.1016/0278-2391(87)90267-9 ◽

1987 ◽

Vol 45 (7) ◽

pp. 577-582 ◽

Cited By ~ 50

Author(s):

Brad A. Theriot ◽

Joseph E. Van Sickels ◽

Robert G. Triplett ◽

Gary J. Nishioka

Keyword(s):

Preliminary Report ◽

Mandibular Fractures ◽

Wire Fixation

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Distal interphalangeal Joint Arthrodesis using only Kirschner Wires in small distal Phalanges

Handchirurgie · Mikrochirurgie · Plastische Chirurgie ◽

10.1055/a-1559-2684 ◽

2021 ◽

Vol 53 (05) ◽

pp. 462-466

Author(s):

Jun-Ku Lee ◽

Soonchul Lee ◽

SeongJu Choi ◽

Dong Hun Han ◽

Jongbeom Oh ◽

...

Keyword(s):

Distal Phalanx ◽

Bony Union ◽

Dash Score ◽

Medical Database ◽

X Ray ◽

Wire Fixation ◽

Distal Interphalangeal ◽

K Wires ◽

Quick Dash

Abstract Purpose To report the clinical and radiographic results of arthrodesis of relatively small-sized distal interphalangeal joints (DIPJs) using only K-wire fixation. Patients and methods Between January 2000 and December 2018 28 arthrodesis in 21 patients (9 males and 12 females with an average age of 52.1 years) with relatively small-sized DIPJs were performed using only K-wires. Data on patient’s characteristics, such as age, sex, affected finger, and the number and size of the used k-wires were collected from the medical database. The narrowest diameter of the cortex and medulla of the distal phalanx was measured on preoperative plain radiographs. The time to union and the arthrodesis angle was determined using serial X-ray radiography follow-up. Preoperatively and at the latest follow-up examination, pain using the visual analogue scale (VAS) and the quick DASH score was registered. In addition, complications were investigated. Results Average follow-up period was 11.4 months. The small finger was mostly affected (n = 12; 42.9 %). The narrowest diameters of the distal phalanx cortex and the medulla measured on preoperative X-ray images were 2.8 mm (SD 0.5) and 1.2 mm (SD 0.4), respectively. Seven fusions were done with use of 1 K-wire, 20 with 2 (71.4 %), and 1 with 3 K-wires. The most common K-wire sizes were 1.1-inch (24 K-wires = 48 %), and 0.9 inch (21 K-wires = 42 %) The preoperative VAS score and quick DASH score improved from 6.1 (range: 0–9) and 25.8 (range: 2–38) to 0.4 (range: 0–2) and 3.4 (range: 0–10.2), respectively. 25 (89.3 %) out of 28 fingers achieved bony union in an average of 96.1 days (range: 58–114) with three non-union. Conclusion Arthrodesis of small DIPJs with K-wire fixation has a high success rate. Therefore, we suggest K-wire fixation as an acceptable alternative for patients with a small phalanx which may be at risk of mismatch with bigger implants. However, concerns remain in terms of fusion delay with K-wire only fixation.

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