A simple method to optimise Kirschner wire fixation of hand fractures

A simple method to optimise Kirschner wire fixation of hand fractures Eur J Plast Surg (2010) 33:307 DOI 10.1007/s00238-010-0459-8 LETTER TO THE EDITOR A simple method to optimise Kirschner wire fixation of hand fractures Waseem Bhat & David Mather Received: 2 May 2010 /Accepted: 24 May 2010 /Published online: 19 June 2010 Springer-Verlag 2010 Sir, Kirschner (K-) wiring is a simple but effective method for holding hand fractures in a reduced position, allowing mobilisation. While placing K-wires, it is of paramount importance to get the path of the wire correct to provide optimum fracture reduction whilst subjecting the tissues to minimal heating [1]. We present a simple method to aid the accurate placement of wires with minimal attempts. A K-wire is used to map out the desired orientation to the wire (Fig. 1) with the aid of X-ray. A marker pen is then used to draw this line on the skin (Fig. 1). The wire is then placed percutaneously using the pen mark as an aid to the three-dimensional spatial awareness needed for competent positioning. The combination of the two-dimensional image and the Fig. 1 K-wire placed over fractured phalanx to mark out desired addition of tactile “feel” give the surgeon a better idea of direction of placement. Direction of K-wire marked on to skin with pen wire direction, hopefully eliminating repeated passes of the wire into the bone. We have found this method to be a If after visualisation under the image intensifier the useful way to give confidence to the junior surgeon under position is suboptimal, the external lines act as a reference supervision and may be used to construct a plan for more as to where the wire should go. difficult fractures. Conflict of interest We declare no conflict of interest (personal or financial) in the publication of this paper. W. Bhat D. Mather Castle Hill Hospital, Hull, Cottingham, UK References W. Bhat (*) 8 Nook Green, 1. Matthews LS, Green CA, Goldstein SA (1984) The thermal effects Wakefield WF3 1ER, UK of skeletal fixation-pin insertion in bone. J Bone Joint Surg Am 66 e-mail: wbhat@hotmail.com (7):1077–1083 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Plastic Surgery Springer Journals

A simple method to optimise Kirschner wire fixation of hand fractures

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Publisher
Springer-Verlag
Copyright
Copyright © 2010 by Springer-Verlag
Subject
Medicine & Public Health; Plastic Surgery
ISSN
0930-343X
eISSN
1435-0130
D.O.I.
10.1007/s00238-010-0459-8
Publisher site
See Article on Publisher Site

Abstract

Eur J Plast Surg (2010) 33:307 DOI 10.1007/s00238-010-0459-8 LETTER TO THE EDITOR A simple method to optimise Kirschner wire fixation of hand fractures Waseem Bhat & David Mather Received: 2 May 2010 /Accepted: 24 May 2010 /Published online: 19 June 2010 Springer-Verlag 2010 Sir, Kirschner (K-) wiring is a simple but effective method for holding hand fractures in a reduced position, allowing mobilisation. While placing K-wires, it is of paramount importance to get the path of the wire correct to provide optimum fracture reduction whilst subjecting the tissues to minimal heating [1]. We present a simple method to aid the accurate placement of wires with minimal attempts. A K-wire is used to map out the desired orientation to the wire (Fig. 1) with the aid of X-ray. A marker pen is then used to draw this line on the skin (Fig. 1). The wire is then placed percutaneously using the pen mark as an aid to the three-dimensional spatial awareness needed for competent positioning. The combination of the two-dimensional image and the Fig. 1 K-wire placed over fractured phalanx to mark out desired addition of tactile “feel” give the surgeon a better idea of direction of placement. Direction of K-wire marked on to skin with pen wire direction, hopefully eliminating repeated passes of the wire into the bone. We have found this method to be a If after visualisation under the image intensifier the useful way to give confidence to the junior surgeon under position is suboptimal, the external lines act as a reference supervision and may be used to construct a plan for more as to where the wire should go. difficult fractures. Conflict of interest We declare no conflict of interest (personal or financial) in the publication of this paper. W. Bhat D. Mather Castle Hill Hospital, Hull, Cottingham, UK References W. Bhat (*) 8 Nook Green, 1. Matthews LS, Green CA, Goldstein SA (1984) The thermal effects Wakefield WF3 1ER, UK of skeletal fixation-pin insertion in bone. J Bone Joint Surg Am 66 e-mail: wbhat@hotmail.com (7):1077–1083

Journal

European Journal of Plastic SurgerySpringer Journals

Published: Oct 1, 2010

References

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