Outcome of Buried Versus Exposed Kirchner Wires in Terms of Infection in Fractures of Phalanges and Metacarpal Bones of Hand

Abstract

Introduction and objectiveThe fracture of hand bones is very common among manual hand workers and a fractured hand imparts a great effect on a person's productivity both socioeconomically and from a body image point of view. The most common method of hand fractures fixation is with the help of Kirschner wires. Kirchner wires can be inserted in exposed or in buried manner. There are a few studies that provide a comparative analysis of rate of infection between these two techniques. This study aimed to assess the rate of infection in buried versus exposed Kirschner (K)-wires for hand fractures.

Buried or exposed Kirschner wire for the management of hand and forearm fractures: A systematic review, meta-analysis, and meta-regression

“…After removing duplicates and screening studies based on their titles and abstracts, 140 studies were removed, leaving 26 studies. These 26 studies were assessed in a full-text form where 15 studies did not meet our eligibility criteria as follows: 8 studies were conducted on patients with humeral fractures, 2 studies did not have any control group, 2 studies did not have data on the outcome of interest, 1 study was only review article, 1 study did not use K-wire for all of the participants, and 1 study was not published in the English language, thus only 11 studies [9,10,[17][18][19][20][21][22][23][24][25] were included in the final analysis Fig 1 . Of these 11 studies, 5 were prospective RCTs and 6 were retrospective cohort studies. The number of samples ranged from 52 to 695 with the duration of follow-up varying from 6 weeks to 1 year.…”

“…The risk of bias assessment by using the RoB v2 tool revealed that only 1 RCT [9] had a "low risk" of bias in all five assessment domains. The remaining four RCTs [10,[17][18][19] were judged to have "some concern" risk of bias. One RCT [18] used consecutive non-random sampling for the selection of participants which was deemed an inappropriate method for randomization, but there was no significant difference in the baseline characteristics of participants in the two groups of intervention, suggesting no serious problems during randomization, therefore was judged to have "some concern" risk of bias in the randomization process.…”

“…The remaining four RCTs [10,[17][18][19] were judged to have "some concern" risk of bias. One RCT [18] used consecutive non-random sampling for the selection of participants which was deemed an inappropriate method for randomization, but there was no significant difference in the baseline characteristics of participants in the two groups of intervention, suggesting no serious problems during randomization, therefore was judged to have "some concern" risk of bias in the randomization process. Two RCTs [10,17] did not mention in detail the blinding of the outcome assessors, therefore were judged to have "some concern" risk of bias in the measurement of the outcome.…”

Buried or Exposed Kirschner Wire for the Management of Hand and Forearm Fractures: A Systematic Review, Meta-Analysis, and Meta-Regression

“…The risk of bias assessment by using the RoB v2 tool revealed that only 1 RCT [9] had a "low risk" of bias in all five assessment domains. The remaining four RCTs [10,[17][18][19] were judged to have "some concern" risk of bias. One RCT [18] used consecutive non-random sampling for the selection of participants which was deemed an inappropriate method for randomization, but there was no significant difference in the baseline characteristics of participants in the two groups of intervention, suggesting no serious problems during randomization, therefore was judged to have "some concern" risk of bias in the randomization process.…”