kirschner wires
Recently Published Documents


TOTAL DOCUMENTS

377
(FIVE YEARS 82)

H-INDEX

27
(FIVE YEARS 2)

2022 ◽  
pp. 175319342110676
Author(s):  
Alastair Kiszely ◽  
Grey Giddins

During hand surgery, tendons may be at risk of damage. This biomechanical study aims to assess the risk of tendon rupture due to passage of Kirschner wires or hypodermic needles. Porcine extensor tendons were divided into four groups. Group 1: a control group was tested to ensure that repeated stress alone did not cause failure. Group 2a: 1.1-mm Kirschner wires were hand pushed through tendons 50 times and then stressed to 40 N, repeated until tendon failure. In Group 2b, K-wires were passed while rotating using a drill. Group 3: the experiment was repeated using a 20 G hypodermic needle. Group 2a tendons required a median of 2450 passes (1150–3500) to propagate failure, Group 2b a median of 2250 (1200–3850) and Group 3a median of 200 passes (150–450). The risk of tendon rupture from wires or hypodermic needles in procedures appears very low.


2021 ◽  
Author(s):  
Marcell Varga

Abstract BackgroundDistal radius fractures are very common in paediatric patients. Severely displaced fractures may require surgical intervention. The gold standard surgical method is percutaneous K-wire osteosynthesis followed by immobilisation. Metal implants can be removed with a second intervention; however, these extra procedures can cause further complications. Several studies confirm the benefits of bioabsorbable implants for paediatric patients. The aim of this retrospective study was to compare the complication rates of displaced distal metaphyseal radius and forearm fractures in children operated on with K-wires versus a novel technique with bioresorbable implants.MethodsWe retrospectively reviewed 94 patients in three paediatric trauma centres who underwent operations due to severely displaced distal forearm or metaphyseal radial fractures between January 2019 and January 2020. The mean age was 8.23 (ranging from 5-12). 30 patients (bioresorbable group, BR-group) were treated with biodegradable PLGA implants (Bioretec®, ActivaPin®), 40 patients with one or two stainless steel Kirschner-wires (K-wires, Sanatmetal®) which were buried under the skin (KW I-group) and 30 children with K-wires left outside the skin. (KWII. Group). We examined the number of minor and major complications as well as the need for repeated interventions. Follow-up was at least one year.ResultsThere was no significant difference between the complication rates at the two KW groups (p = 0.241; Cramer’s V = 0.211), while the complication rate of the BR group was significantly lower. (p = 0.049; Cramer’s V = 0.293 and p = 0.002; Cramer’s V = 0.418 respectively). No later than half a year after the injury, no difference was observed between the functional outcomes of the patients in each group. One and a half years after the injury, no signs of growth disturbance were found in any of the children. No second surgical intervention was required in the BR group.ConclusionsSurgeries with bioresorbable intramedullary implants may have fewer complications than K- wire osteosynthesis in the treatment of severely displaced distal forearm fractures. The benefits are most pronounced in the first six weeks after surgery, reducing the number of outpatient visits and increasing the child's sense of comfort. As no second intervention is required, this can lead to significant cost savings. After half a year, there is no difference in the outcomes between the different surgical treatment strategies.


Author(s):  
Daniel Lynch ◽  
John P. Mickley ◽  
Adam Gordon ◽  
Austin J. Roebke ◽  
Kanu S. Goyal

2021 ◽  
Vol 27 (5) ◽  
pp. 597-609
Author(s):  
Yu.D. Kim ◽  
◽  
D.S. Shitikov ◽  
N.A. Knyazev ◽  
N.E. Likholatov ◽  
...  

Abstract. Introduction Treatment of patients with acute fractures of the patella is the task of the trauma and orthopedic service and should provide restoration of the integrity of the bone tissue and the extensor apparatus of the knee joint for its early mobilization. There is an opinion that conservative treatment cannot meet requirements of patients’ quality of life, and therefore, most traumatologists are inclined to surgically treat patellar fractures. Purpose Based on the available literature data, to determine the most rational way to treat patients with patellar fractures Materials and methods Available studies published in the last 10 years were analyzed. The databases NCBI Pubmed, Healio Orthopedics, Medline were searched. Results Such osteosynthesis methods as patella suture, osteosynthesis with plates, special internal devices, external fixation devices, Kirschner wires and wire cerclage, various screws were covered. The question of clinical application of patellectomy was touched upon; the contribution of the Department of Traumatology, Orthopedics and Urgent Surgery of the Krasnov Samara State Medical University to the development of operative techniques of osteosynthesis of the patella, the basic concepts of scientific research, and also the most optimal ways of treating patients with patellar fractures were described. Conclusion The conservative method of treating patients with patellar fractures is most relevant if there are contraindications to surgery. It inevitably leads to persistent arthrogenic contracture. The best functional results of treatment have been achieved with surgical treatment due to the possibility of early mobilization of the knee joint. According to the data of available studies, plates and screws as well as osteosynthesis with Kirschner wires and wiring cerclage show maximum stability. There is evidence of a direct correlation between the risk of developing infectious complications and pain in the postoperative period and the number of elements of subcutaneous metal implants. Thus, the most optimal way to treat closed fractures of the patella is osteosynthesis with the use of wires and wire cerclage according to the tension band principle.


Author(s):  
Dong Chul Lee ◽  
Jung Hyun Park ◽  
Sung Hoon Koh ◽  
Jin Soo Kim ◽  
Kyung Jin Lee ◽  
...  

Purpose: The purpose of this study was to compare the clinical and radiological results of patients with fifth metacarpal neck fractures using different sizes and numbers of Kirschner wires (K-wire).Methods: A single institutional retrospective review identified 67 patients with a fifth metacarpal neck fracture between January 2015 and July 2020. The minimum follow-up time was 6 months and they were all treated within 6.4 days of the initial injury. Either one K-wire (1.6 mm), two K-wires (1.1 mm), or three K-wires (0.9 mm) was used. We analyzed the bone union period, and K-wire removal period, duration of surgery, total active motion, intramedullary diameter, pre/postoperative shortening, and pre/postoperative angulation clinically. We used a Method of Shortening Stipulated to measure shortening and the Medullary Canal-lateral view method for angulation. The intramedullary diameter was measured in the mid-shaft of the fifth metacarpal bone in the coronal view. Total active motion was measured at the time of follow-up in our outpatient department.Results: Clinical and radiological parameters showed no statistically significant differences. Even though it did not present a statistical significance, the absolute mean duration of surgery was the shortest in a single K-wire group. Conclusion: The clinical and radiological outcomes of surgery were comparable regardless of the number of K-wires inserted. However, we could look forward to gaining potential benefit from shortened operation time in a single K-wire group. Since stable fixation can be obtained even if one K-wire is used, inserting one thick K-wire into the intramedullary canal can be an alternative according to the surgeon’s preference.


2021 ◽  
Vol 29 (5) ◽  
pp. 263-267
Author(s):  
HENRIQUE MELO NATALIN ◽  
JÉSSICA COLAMARINO SESSA DA SILVA ◽  
JOSÉ BATISTA VOLPON

ABSTRACT Objective: To compare the outcomes of the fixation of complete and displaced supracondylar humeral fractures in children with two different Kirschner wire configurations. Methods: The type of fixation was randomized to either crossed (19 cases), or two divergent lateral Kirschner wires (24 cases). The comparison was made six months later between the two treated groups and each group with the non-fractured elbow (clinical alignment, range of motion, Baumann angle, and lateral humeral capitellar angle). Results: 43 children were evaluated (65% boys) with a mean age of six years and five months. The carrying angle (p = 0.94), extension (p = 0.89), and the Flynn´s criteria (p = 0.56) were similar between the groups. The flexion was slightly smaller for the crossed wire group (p = 0.04), but similar to the uninjured side. The Baumann angle was not different between the two fixations (p = 0.79) and the contralateral side (p = 0.1). The lateral humeral capitellar angle was slightly greater for the lateral pinning (p = 0.08), but with no difference with the uninjured elbow (p = 0.62). No iatrogenic injuries were observed. Conclusion: Both fixations presented similar outcomes that did not significantly affect the carrying angle in relation to the non-fractured side. Level of evidence II, Therapeutic study - Investigating the results of treatment.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Karim Samir Masoud ◽  
Ahmad Fathi El Sherif ◽  
Raghda Elsayed Tallal ◽  
Mahmoud Mahrous Mohamed Waly

Abstract Background Metacarpal fractures are among the most common fractures of the skeletal system and account for 36 % of hand and wrist fractures. Aim of the Work To determine the functional outcome and postoperative complications for both these surgical techniques in the treatment of second and third metacarpal bones fractures. Patients and Methods The systematic review was restricted to clinical studies of both these surgical techniques in the treatment of closed second and third metacarpal fractures. We reviewed studies that include management of metacarpal fractures with open reduction and internal fixation using plate and screws versus percutaneous crossed Kirschner wires fixation. Results No specification was made about the type of fracture, other than shaft fractures located in the second and the third metacarpal. All fractures were operated because of instability, angulations’ or rotational deformity. No comparison can therefore be made between fracture type (i.e. spiral, oblique) and functional results. As all studies reported identical indication for surgical fixation a comparison between type of fixation and functional result can be made. Conclusion Based on the reported results there is no evidence to suggest one fixation technique over another. The reported complications however for ORIF and K-wire fixation in the treatment of metacarpal fractures are unmistakably different for the two types of fixation.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Asmaa A Al Sabbagh ◽  
Ashraf M Farid ◽  
Mohamed A El Rouby ◽  
Sarah A Abdalmaksoud

Abstract Background Autologous Platelet gel may become an ideal autologously prepared biologic blood-derived product that can be exogenously applied to a diversity of tissues, in which it releases high concentrations of platelet growth factors that enhance healing. Aim of the Work to evaluate the role of platelet gel in promoting healing in phalangeal fractures. Patients and Methods This study was conducted on 20 Patients were operated either by general or local anesthesia in a prospective interventional study for: evaluation the role of platelet gel in promoting healing of phalangeal fractures after fixation by Kirschner wires. Results In this study: clinical and radiographic signs of healing at 12wks were achieved in 70% of studied patients and 16wks were achieved in 30% of studied patients and early improvement of swelling and tenderness. Conclusion The use of Autologous platelet gel in phalangeal fractures after fixation by Kirschner wires gives a significant improvement quickly over the periods according to swelling, tenderness and x-ray healing So decrease recovery time and return to work and activities.


Hand ◽  
2021 ◽  
pp. 155894472110431
Author(s):  
Chao Long ◽  
Jung Ho Gong ◽  
Scott D. Lifchez

Background Hand deformities secondary to scleroderma can limit activities of daily living and be associated with substantial disability. This study aimed to evaluate the outcomes following arthrodesis performed to treat digital contractures secondary to scleroderma. Methods We performed a retrospective review of all patients with scleroderma who underwent arthrodesis by a single surgeon from 2015 to 2020. We collected demographic information, operative variables, and outcomes variables. Our primary outcome was occurrence of any postoperative complication, which we defined to include wound dehiscence, digital ischemia, malunion, nonunion, cellulitis, and osteomyelitis. We calculated descriptive statistics and performed all analyses at the joint level. Results We identified 9 patients who underwent arthrodesis of 19 joints. All patients were women with a mean age of 55.3 years. At the time of surgery, most patients were taking disease-modifying antirheumatic drugs (DMARDs). Kirschner wires (K-wires) were used in most cases (n = 18), 15 of which were removed uneventfully at an average of 4.8 months after surgery. With a mean follow-up time of 15.4 months, the overall complication rate was 5.3% (n = 1). This patient developed digital ischemia in 1 of 4 operative digits, which became gangrenous and required amputation. Conclusions Our study suggests that arthrodesis can be performed safely in the scleroderma hand, even when patients are taking DMARDs. Given the uneventful K-wire removal in all joints and the high risk of exposure of buried hardware in this population, we recommend nonpermanent placement of K-wires. Hand surgeons may consider arthrodesis in the scleroderma hand before proceeding to revision amputation.


Sign in / Sign up

Export Citation Format

Share Document