Arthrodesis of the Interphalangeal Joint of the Hallux

2001 ◽  
Vol 91 (8) ◽  
pp. 427-434 ◽  
Author(s):  
Gerard V. Yu ◽  
Frank E. Vargo ◽  
Joel W. Brook
Keyword(s):  
Simple Technique ◽  
Functional Unit ◽  
Screw Fixation ◽  
Kirschner Wire ◽  
Interphalangeal Joint ◽  
Kirschner Wires ◽  
Effective Technique ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Common Problems

The authors present a simple and effective technique to achieve arthrodesis of the hallucal interphalangeal joint. Stabilization is achieved by external fixation with crossing Kirschner wires joined together to create a single functional unit, a technique that avoids common problems often associated with Kirschner-wire fixation. The authors propose that this simple technique be considered for patients in whom it has been determined that screw fixation should not be used to obtain fusion of the interphalangeal joint. (J Am Podiatr Med Assoc 91(8): 427-434, 2001)

scholarly journals UK DRAFFT: a randomised controlled trial of percutaneous fixation with Kirschner wires versus volar locking-plate fixation in the treatment of adult patients with a dorsally displaced fracture of the distal radius

2015 ◽  
Vol 19 (17) ◽  
pp. 1-124 ◽  
Author(s):  
Matthew L Costa ◽  
Juul Achten ◽  
Caroline Plant ◽  
Nick R Parsons ◽  
Amar Rangan ◽  
...  
Keyword(s):  
Distal Radius ◽  
Locking Plate ◽  
Plate Fixation ◽  
Kirschner Wire ◽  
Health Technology ◽  
Kirschner Wires ◽  
Locking Plate Fixation ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Displaced Fracture

BackgroundIn high-income countries, 6% of all women will have sustained a fracture of the wrist (distal radius) by the age of 80 years and 9% by the age of 90 years. Advances in orthopaedic surgery have improved the outcome for patients: many such fractures can be treated in a plaster cast alone, but others require surgical fixation to hold the bone in place while they heal. The existing evidence suggests that modern locking-plate fixation provides improved functional outcomes, but costs more than traditional wire fixation.MethodsIn this multicentre trial, we randomly assigned 461 adult patients having surgery for an acute dorsally displaced fracture of the distal radius to either percutaneous Kirschner-wire fixation or locking-plate fixation. The primary outcome measure was the Patient-Rated Wrist Evaluation©(PRWE) questionnaire at 12 months after the fracture. In this surgical trial, neither the patients nor the surgeons could be blind to the intervention. We also collected information on complications and combined costs and quality-adjusted life-years (QALYs) to assess cost-effectiveness.ResultsThe baseline characteristics of the two groups were well balanced and over 90% of patients completed follow-up. Both groups of patients recovered wrist function by 12 months. There was no clinically relevant difference in the PRWE questionnaire score at 3 months, 6 months or 12 months [difference at 12 months: –1.3; 95% confidence interval (CI) –4.5 to 1.8;p = 0.398]. There was no difference in the number of complications in each group and small differences in QALY gains (0.008; 95% CI –0.001 to 0.018); Kirschner-wire fixation represents a cost-saving intervention (–£727; 95% CI –£588 to –£865), particularly in younger patients.ConclusionsContrary to the existing literature, and against the increasing use of locking-plate fixation, this trial shows that there is no difference between Kirschner wires and volar locking plates for patients with dorsally displaced fractures of the distal radius. A Kirschner-wire fixation is less expensive and quicker to perform.Trial registrationCurrent Controlled Trials ISRCTN31379280.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 19, No. 17. See the NIHR Journals Library website for further project information.

The Treatment of Dorsal Fracture-Dislocation of the Proximal Interphalangeal Joint by Closed Reduction and Kirschner Wire Fixation: A 16-Year Follow Up

2001 ◽  
Vol 26 (6) ◽  
pp. 537-540 ◽  
Author(s):  
D. P. NEWINGTON ◽  
T. R. C. DAVIS ◽  
N. J. BARTON
Keyword(s):  
Closed Reduction ◽  
Articular Surface ◽  
Kirschner Wire ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Fracture Dislocation ◽  
Long Term Results ◽  
Kirschner Wire Fixation ◽  
Wire Fixation

Ten patients who had sustained 11 unstable dorsal fracture-dislocations of finger proximal interphalangeal joints were reviewed at a mean follow-up of 16 years. All had been treated acutely by closed reduction and transarticular Kirschner wire fixation of the proximal interphalangeal joint, without any attempt at reduction of the fracture of the base of the middle phalanx, which probably involved 30–60% of the articular surface. Seven of the ten patients complained of no finger pain or stiffness, and none complained of severe pain. There was a mean fixed flexion deformity of 81 at the proximal interphalangeal joint, which had a mean arc of movement of 851. Although subchondral sclerosis and mild joint space narrowing were observed in some instances, there were no severe degenerative changes. These results confirm that this technique is a reliable treatment method for these injuries, and produces satisfactory long-term results.

Outcome of Proximal Chevron Osteotomy for Hallux Valgus With and Without Transverse Kirschner Wire Fixation

2008 ◽  
Vol 29 (11) ◽  
pp. 1101-1106 ◽  
Author(s):  
Keun-Bae Lee ◽  
Chang-Young Seo ◽  
Chang-Ich Hur ◽  
Eun-Sun Moon ◽  
Jae-Jun Lee
Keyword(s):  
Hallux Valgus ◽  
Kirschner Wire ◽  
Kirschner Wires ◽  
Fixation Group ◽  
Chevron Osteotomy ◽  
Kirschner Wire Fixation ◽  
Group I ◽  
Wire Fixation ◽  
Group Ii ◽  
Severe Hallux Valgus

Background: Proximal chevron osteotomy (PCO) for hallux valgus is inherently more stable than the other forms of proximal metatarsal osteotomy, but complications, such as, delayed union, nonunion, and malunion can occur. In this study, we have compared results of two axial Kirschner wire fixation with or without transverse Kirschner wires in PCO for moderate to severe hallux valgus deformities. Methods: A prospective study was conducted on 65 patients (85 feet) that underwent PCO and a distal soft tissue procedure for moderate to severe hallux valgus. Patients were divided into two groups, two axial Kirschner wire fixation (Group I) and two axial and supplementary transverse Kirschner wire fixation (Group II). Group I comprised 41 feet of 32 patients and Group II 44 feet of 33 patients. Results: Average AOFAS scores were 52.8 points in group I and 49.6 points in group II preoperatively, and 92.8 and 89.6 points, respectively, at last followup. Patients were very satisfied or satisfied in 92.7% in Group I and 93.2% in Group II. Average hallux valgus angles in Groups I and II changed from 34.9 degrees and 37.2 degrees preoperatively to 12.3 degrees and 13.9 degrees postoperatively, and intermetatarsal angles in Groups I and II changed from an average of 17.9 degrees and 17.2 degrees preoperatively to 10.3 degrees and 10.4 degrees postoperatively. No significant inter-group differences were found. Conclusion: Supplementary transverse Kirschner wire fixation is not recommended for proximal metatarsal chevron osteotomy since two axial Kirschner wires provided sufficient stability. Level of Evidence: I, Prospective Radomized Study

scholarly journals Fractures of the Zygomaticomaxillary Complex and Their Treatment: A Case Report

2016 ◽  
Vol 20 (1) ◽  
pp. 40-43
Author(s):  
Esat Bardhoshi
Keyword(s):  
Case Report ◽  
Screw Fixation ◽  
Kirschner Wire ◽  
Rigid Fixation ◽  
Facial Fractures ◽  
Titanium Plate ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Wire Osteosynthesis ◽  
Zygomaticomaxillary Complex

SummaryFractures of the zygomaticomaxillary complex are the second most common of all facial fractures. Several fixation methods have been used over the years, including wire osteosynthesis, lag screw fixation, transfacial Kirschner wire fixation, titanium plate and screw fixation, and more recently, resorbable plating system. Internal fixation with titanium plates and screw provides the most rigid fixation and thus greater immobility of the fracture segments. The degree of immobilization created with titanium plates and screws also allows fixation at fewer anatomic points.

HEMI-HAMATE ARTHROPLASTY VERSUS TRANSARTICULAR KIRSCHNER WIRE FIXATION FOR UNSTABLE DORSAL FRACTURE-DISLOCATION OF THE PROXIMAL INTERPHALANGEAL JOINT IN THE HAND

Hand Surgery ◽  
2015 ◽  
Vol 20 (01) ◽  
pp. 115-119 ◽  
Author(s):  
R. C. Barksfield ◽  
B. Bowden ◽  
A. J. Chojnowski
Keyword(s):  
Bone Grafting ◽  
Kirschner Wire ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Fracture Dislocation ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Fracture Dislocations ◽  
Fixed Flexion Deformity

Following the introduction of the hemi-hamate arthroplasty (HHA) technique to our unit, we sought to evaluate the early clinical outcomes achieved with this method of fixation and compare these with simple trans-articular Kirschner wire (K-wire) fixation for dorsal fracture dislocations (DFD) of the proximal interphalangeal joint (PIPJ). Ninteen patients underwent fixation of these injuries with either K-wire fixation (12/19) or hemi-hamate bone grafting (7/19) between 2005 and 2011. At a mean follow-up of 14 weeks median arc of movement at the PIPJ was 65° (range 31° to 108°) following HHA and 56° (range 9° to 85°) (p = 0.82) following temporary transarticular K-wire fixation. Median fixed flexion deformity (FFD) was 20° and 15° for hemi-hamate bone grafting and K-wire fixation respectively. Based upon our findings, transarticular K-wire fixation produced equivalent outcomes to HHA for unstable DFD of the PIPJ in the hand.

Dorsal Fracture–Dislocation of the Proximal Interphalangeal Joint: A Comparative Study of Percutaneous Kirschner Wire Fixation Versus Open Reduction and Internal Fixation

2005 ◽  
Vol 30 (2) ◽  
pp. 120-128 ◽  
Author(s):  
A. ALADIN ◽  
T. R. C. DAVIS
Keyword(s):  
Internal Fixation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Kirschner Wire ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Fracture Dislocation ◽  
Cerclage Wire ◽  
Kirschner Wire Fixation ◽  
Wire Fixation

Nineteen patients with a dorsal fracture–dislocation of the proximal interphalangeal joint of a finger were treated with either closed reduction and transarticular Kirschner wire fixation (eight cases) or open reduction and internal fixation, using either one or two lag screws (six cases) or a cerclage wire (five cases). At a mean follow-up of 7 (range 6–9) years, most patients reported satisfactory finger function, even though some of the injuries healed with proximal interphalangeal joint incongruency (seven cases) or subluxation (four cases). Those treated by open reduction complained of more “loss of feeling” in the affected finger and those specifically treated by cerclage wire fixation reported more cold intolerance and had a significantly larger fixed flexion deformity (median, 30°: range 18–38°) and a smaller arc of motion (median, 48°: range 45–60°) at the proximal interphalangeal joint, despite having the best radiological outcomes. Closed reduction and transarticular Kirschner wire fixation produced satisfactory results, with none of the eight patients experiencing significant persistent symptoms despite a reduced arc of proximal interphalangeal joint flexion (median=75°; range 60–108°). The results of this relatively simple treatment appear at least as satisfactory as those obtained by the two techniques of open reduction and internal fixation, both of which were technically demanding.

THUMB METACARPOPHALANGEAL ARTHRODESIS WITH LOCAL BONE GRAFTING

Hand Surgery ◽  
2011 ◽  
Vol 16 (01) ◽  
pp. 55-61 ◽  
Author(s):  
Rebel Huffman ◽  
Ghazi M. Rayan
Keyword(s):  
Pain Relief ◽  
Bone Graft ◽  
Kirschner Wire ◽  
Union Rate ◽  
Effective Technique ◽  
Kirschner Wire Fixation ◽  
Local Bone ◽  
Wire Fixation ◽  
Contralateral Hand

A restrospective study identified 47 thumb MP joints in 41 patients who underwent arthrodeses using cup and cone osteotomy secured with Kirschner-wire fixation and augmented with local bone graft from the thumb metacarpal. Union rate was 96% averaging 6.8 weeks. Two patients had nonunion; 6.3 year follow-up of 15 thumbs showed improvement of or no pain. MHQ scores were 56.5 in the operative hand and 66.7 in the contralateral hand. Thumb MP arthrodesis augmented with local bone graft negates the morbidity of obtaining distant graft. It is a safe and effective technique that provides excellent pain relief with an acceptable union rate.

Stabilization of the Interphalangeal Joint of the Big Toe: Comparison of Three Methods

Foot & Ankle ◽  
1992 ◽  
Vol 13 (4) ◽  
pp. 181-187 ◽  
Author(s):  
Rajan Asirvatham ◽  
Ronald J. Rooney ◽  
H. G. Watts
Keyword(s):  
Screw Fixation ◽  
Kirschner Wire ◽  
Interphalangeal Joint ◽  
Kirschner Wire Fixation ◽  
Extensor Hallucis Longus ◽  
Group A ◽  
C 32 ◽  
Group B ◽  
Intramedullary Screw ◽  
Extensor Digitorum Brevis

Three methods of stabilizing the IP of the big toe were compared. In group A, 10 patients underwent tenodesis of the extensor hallucis longus to the extensor digitorum brevis tendon. All of them developed a toe-drop; two patients had significant symptoms that required IP fusion. In group B, 19 patients underwent IP fusion using smooth or threaded intramedullary Kirschner wire fixation. There were nine nonunions, three requiring refusion. In group C, 32 patients underwent IP fusion using intramedullary screw fixation. There was one nonunion with screw failure that required revision. Although none of our patients considered the toe-drop after extensor hallucis longus tenodesis cosmetically unacceptable, this may not be so in other cultures. All complications following IP fusion with screw fixation were technical and are avoidable. When stabilization of IP is required, we recommend fusion of IP with screw fixation.

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