Hammering K-Wires is Superior to Drilling with Irrigation

Franssen, Bas B. G. M.; Schuurman, Arnold H.; Brouha, Pascal C. R.; Kon, Moshe

doi:10.1007/s11552-008-9153-8

Cited by 7 publications

(3 citation statements)

References 21 publications

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“…Drilling across a finger joint can lead to heat osteonecrosis and destruction of the joint [3,7,37], however we did not observe this complication. An IP joint transfixation had also no impact on the clinic outcome.…”

Section: Discussioncontrasting

confidence: 66%

Surgical treatment of the bony mallet thumb: a case series and literature review

Kastenberger

Kaiser

Benedikt

et al. 2022

Arch Orthop Trauma Surg

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Introduction The aim of this study was to provide a more precise statement on the outcome after surgical treatment of a bony mallet thumb and possibly give a treatment recommendation regarding the surgical fixation method. Patients and methods All patients (n = 16) who underwent a surgical treatment for an acute bony mallet thumb fracture between January 2006 and July 2019 were enrolled. The surgical method, complications, the range of motion, tip pinch, lateral key pinch, overall grip strength, visual analog score, Disability of the Arm, Shoulder and Hand Score, Mayo Wrist Score, Patient-Rated Wrist Evaluation Score, Buck-Gramcko Score and radiologic parameters were evaluated. Further, a comprehensive literature search on PubMed was conducted covering a period from 1956 to 2021 to include all possible matching articles on the treatment of the bony mallet thumb (n = 21 articles). Results Surgical treatment was very inhomogenous including indirect and direct K-wire fixation, screw fixation, plate fixation and anchor fixation methods. The IP joint range of motion and thumb strength ranged from 66 to 94% in comparison to the contralateral side. An open reduction led to worse functional scores compared to a closed reduction. Treatment methods in the literature were also very inhomogenous with a very low patient count, often even pooling data of bony mallet thumb fractures with bony mallet finger fractures. The risk for infection was higher in K-wire fixation methods than in open reduction and internal fixation methods. Conclusion The evidence for the best treatment of a bony mallet thumb fracture is low. On one hand the functional outcome can be inferior using an open reduction approach, but on the other hand, K-wire fixation methods with a closed reduction approach showed a higher risk for infection. Future multi-center research must be conducted to find the best treatment procedure for the best outcome of the patient.

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Section: Discussioncontrasting

confidence: 66%

Surgical treatment of the bony mallet thumb: a case series and literature review

Kastenberger

Kaiser

Benedikt

et al. 2022

Arch Orthop Trauma Surg

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“…3 It is an irreversible insult that has been shown to result in poor healing potential. It is often observed in the percutaneous insertion of K-wires, 8 where local temperature can exceed 47°C. 7,11 K-wire temperatures with a single pass have been reported as high as 115°C 14 and can heat up surround tissues in the human finger up to 190°C.…”

Section: Introductionmentioning

confidence: 99%

Temperature Rise in Kirschner Wires Inserted Using Two Drilling Methods: Forward and Oscillation

Anderson

İnceoğlu

Wongworawat

2017

Hand (New York, N,Y.)

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“…A few strategies have been proposed to decrease the heat generation during the drilling, including tip design, drilling technique, and cooling methods [ 7 , 8 , 9 , 11 , 15 , 16 , 17 ]. Hammering, as opposed to rotary drilling, has been one of the more recent trends to reduce the thermal stressing of osteocytes [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Highly Adhesive Antimicrobial Coatings for External Fixation Devices

Bredikhin

Sawant

Gross

et al. 2023

Gels

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Pin site infections arise from the use of percutaneous pinning techniques (as seen in skeletal traction, percutaneous fracture pinning, and external fixation for fracture stabilization or complex deformity reconstruction). These sites are niduses for infection because the skin barrier is disrupted, allowing for bacteria to enter a previously privileged area. After external fixation, the rate of pin site infections can reach up to 100%. Following pin site infection, the pin may loosen, causing increased pain (increasing narcotic usage) and decreasing the fixation of the fracture or deformity correction construct. More serious complications include osteomyelitis and deep tissue infections. Due to the morbidity and costs associated with its sequelae, strategies to reduce pin site infections are vital. Current strategies for preventing implant-associated infections include coatings with antibiotics, antimicrobial polymers and peptides, silver, and other antiseptics like chlorhexidine and silver-sulfadiazine. Problems facing the development of antimicrobial coatings on orthopedic implants and, specifically, on pins known as Kirschner wires (or K-wires) include poor adhesion of the drug-eluting layer, which is easily removed by shear forces during the implantation. Development of highly adhesive drug-eluting coatings could therefore lead to improved antimicrobial efficacy of these devices and ultimately reduce the burden of pin site infections. In response to this need, we developed two types of gel coatings: synthetic poly-glycidyl methacrylate-based and natural-chitosan-based. Upon drying, these gel coatings showed strong adhesion to pins and remained undamaged after the application of strong shear forces. We also demonstrated that antibiotics can be incorporated into these gels, and a K-wire with such a coating retained antimicrobial efficacy after drilling into and removal from a bone. Such a coating could be invaluable for K-wires and other orthopedic implants that experience strong shear forces during their implantation.

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Hammering K-Wires is Superior to Drilling with Irrigation

Cited by 7 publications

References 21 publications

Surgical treatment of the bony mallet thumb: a case series and literature review

Surgical treatment of the bony mallet thumb: a case series and literature review

Temperature Rise in Kirschner Wires Inserted Using Two Drilling Methods: Forward and Oscillation

Highly Adhesive Antimicrobial Coatings for External Fixation Devices

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