Fixation of Kirschner wires: a comparison between hammering and drilling k-wires into ribs of pigs

Wassenaar, Eelco B.; Franssen, Bas B. G. M.; Egmond, D. B. van; Kon, Moshe

doi:10.1007/s00238-006-0070-1

Cited by 8 publications

(16 citation statements)

References 23 publications

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“…This is in agreement with previous in vitro results of Wassenaar et al [24] and Zegunis et al [26]. It must be stated, however, that drilling time in the present experiment was relatively long compared to that of studies mentioned above.…”

Section: Discussionsupporting

confidence: 94%

“…Surprisingly, results of the present study show that, in vivo, extraction and torque forces are equal for hammered and drilled K-wires. The same equipment was used in a previous study, but during this experiment, the insertion force was increased during K-wire insertion [24]. We think, however, that the contrast is due to the models used, pig ribs vs rabbit limbs.…”

Section: Discussionmentioning

confidence: 99%

“…Hammering has some advantages compared to drilling in vitro, including lower temperatures, better initial fixation, and shorter insertion time [24,26]. However, to our knowledge, there are no reports of biomechanical aspects of hammered K-wires in vivo.…”

Section: Introductionmentioning

confidence: 99%

“…Hammering was performed with a Lithoclast hammering device [24] (EMS Medical GmbH, Konstanz, Germany). The pressure was standardized at 1.0 Bar.…”

Section: Introductionmentioning

confidence: 99%

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In vivo biomechanical comparison of hammering vs drilling of Kirschner wires; a pilot study in rabbits

et al. 2007

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Heat generation due to drilling Kirschner wires (Kwires) into bone can lead to serious complications. Hammering K-wires could be an alternative insertion method because it generates less heat and results in better fixation and a shorter insertion time. There is, however, no in vivo information about insertion time and biomechanics of hammered K-wires. Insertion time was measured when drilling or hammering Kwires into femurs and tibias of 16 rabbits. Four K-wires inserted in one hind limb were used to measure extraction and torque forces directly after insertion (T = 0) and four K-wires inserted in the contralateral hind limb were used for the same measurements 4 weeks after insertion (T = 4). The insertion time for hammering was significantly shorter compared to drilling. Extraction and torque properties measured at T = 0 and T = 4 were equal for both techniques. Hammering, however, resulted in more cracks. Based on these results neither of these methods can be identified as a superior technique to insert K-wires in fragile bones.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Hammering was performed with a Lithoclast hammering device [24] (EMS Medical GmbH, Konstanz, Germany). The pressure was standardized at 1.0 Bar.…”

Section: Introductionmentioning

confidence: 99%

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In vivo biomechanical comparison of hammering vs drilling of Kirschner wires; a pilot study in rabbits

et al. 2007

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“…The ultimate K-wire insertion method would be a technique without the necessity of irrigation but with the advantages of drilling and without thermal related complications. K-wire insertion by hammering using a pneumatic hammer could prove to be effective in reaching this goal [ 11 , 23 , 25 ]. It has been shown that hammering of K-wires results in lower heat generation, shorter insertion time, less thermal damage and equal or even better initial fixation compared to drilling without irrigation.…”

Section: Introductionmentioning

confidence: 99%

Hammering K-Wires is Superior to Drilling with Irrigation

Franssen

Schuurman

Brouha

et al. 2008

Hand (New York, N,Y.)

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Cooling during drilling Kirschner wires is not always effective in preventing thermal related damage. In this study, we used a human in vitro model and compared temperature elevation, insertion time, and extraction force between three Kirschner wire insertion methods-drilling with and without irrigation and pneumatic hammering. Forty five Kirschner wires were inserted into 15 fresh human cadaver metacarpals. All three insertion methods were applied in each metacarpal. Drilling without irrigation resulted in a temperature elevation of 67.25±5.4ºC with significantly lower values for drilling with irrigation (4.15± 0.6ºC) and pneumatic hammering (31.52±3.4ºC). The insertion time for pneumatic hammering (47.63±8.8 s) was significantly lower compared to drilling without irrigation (263.16 ±36.5 s) and drilling with irrigation (196.10±28.5 s). Extraction forces after drilling without irrigation, drilling with irrigation, and pneumatic hammering were 39.85±4.1 N, 57.81±6.5 N, and 62.23±6.7 N, respectively. Pneumatic hammering is superior to drilling without irrigation, especially when irrigation is not possible.

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