Postoperative Management of K-Wires in Percutaneous Foot Surgery

Abstract

Introduction: When a Kirschner wire (K-wire) is used percutaneously, the protruding end often causes discomfort and is associated with an increased risk of complications, such as pin loosening, infection, injury, etc. This study was undertaken to determine the ideal postoperative management when using these implants. We describe a surgical alternative for K-wire management in foot surgery. Materials and method:A prospective, descriptive study was conducted. A total of 39 patients (70 procedures) were enrolled in the study and underwent K-wire fixation. All pins were cut short and buried in the subcutaneous tissue of the finger until completely hidden beneath the skin. Demographic and clinical variables were analyzed. Results:The following variables were evaluated: Age, gender, AOFAS score, duration of K-wire stay, antibiotic prophylaxis, diagnosis, previous conditions, pin extrusion and surgical procedure performed. Median duration of K-wire stay was 30 days. All patients were allowed to shower and wet the wound 24 hours following surgery. Conclusion:The method described in our study is easily performed and does not require special equipment or supplies.

Is There a Benefit to Rigid Fixation in Calcaneal Lengthening Osteotomy in Painful Pediatric Idiopathic Flatfoot Deformity? Comparing Results of Kirschner Wire Versus Plate Fixation

“…7,8 Studies show that K-wire fixation in hand and foot surgery yielded complication rates of 14% and 2.85%, respectively. 7,8 Nevertheless, recent studies have demonstrated the utility of plates for their robust allograft fixation for CLO. 4,5 Plate technology used for fracture fixation provides increased allograft stability but potential complications include hardware failure, loosening, plate discomfort, deep tissue infection, greater biological insult due to soft tissue dissection and bone stripping, and nonunion.…”

“…This is the first study comparing outcomes of K-wire fixation and plates for patients receiving CLO in painful pediatric FF. Advantages of using K-wires include lower costs and ease of insertion, whereas disadvantages include higher rates of superficial wound infections, pin site irritation, pin migration, potential loss of reduction, and in rare instances, deep tissue infections and osteomyelitis 7,8 . Studies show that K-wire fixation in hand and foot surgery yielded complication rates of 14% and 2.85%, respectively 7,8 .…”

“…Advantages of using K-wires include lower costs and ease of insertion, whereas disadvantages include higher rates of superficial wound infections, pin site irritation, pin migration, potential loss of reduction, and in rare instances, deep tissue infections and osteomyelitis 7,8 . Studies show that K-wire fixation in hand and foot surgery yielded complication rates of 14% and 2.85%, respectively 7,8 . Nevertheless, recent studies have demonstrated the utility of plates for their robust allograft fixation for CLO 4,5 .…”

“…3 Rigid fixation with plates for this procedure has recently gained popularity due to concerns of loss of correction and infections associated with the use of K-wires. [4][5][6][7][8] Despite providing more stability across the osteotomy site, plates require more soft tissue dissection, may cause peroneal tendon irritation, and require greater periosteal stripping. 9 Plates may also be prominent over the lateral border of the foot where subcutaneous tissue can be thin.…”

“…Because of the inherent stability of this open wedge osteotomy, traditionally Kirschner wire (K-wire) fixation has been used for this procedure 3 . Rigid fixation with plates for this procedure has recently gained popularity due to concerns of loss of correction and infections associated with the use of K-wires 4–8 . Despite providing more stability across the osteotomy site, plates require more soft tissue dissection, may cause peroneal tendon irritation, and require greater periosteal stripping 9 .…”