Infection rate of percutaneous Kirschner wire fixation for distal radius fractures by ProQuest

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To review the infection rate in 43 patients who underwent percutaneous Kirschner wire fixation for distal radius fractures. Records of 13 men and 30 women aged 25 to 86 (mean, 49) years who underwent closed reduction and percutaneous Kirschner wire fixation for unstable distal radius fractures were reviewed. Each fracture was fixed with 2 to 3 wires of 1.6-mm diameter. Kirschner wires were left protruding through the skin for easy removal, with their ends bent outside the skin to prevent migration. Wounds were cleaned and dressed with gauze and a plaster-of-Paris cast was applied. The severity of the pin tract infection was graded according to the modified Oppenheim classification. Nine (21%) of the patients developed pin tract infection (3 grade 1, 3 grade 2, 2 grade 3, and one grade 4). Three patients underwent early removal of the Kirschner wires at week 3. The infection rate after percutaneous Kirschner wire fixation is unacceptable. Kirschner wires should be buried under the skin to decrease the infection rate.

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									Journal of Orthopaedic Surgery ���������������




Infection rate of percutaneous Kirschner wire
fixation for distal radius fractures
Palaniappan Lakshmanan, Varun Dixit, Mike R Reed, Joel Lester Sher
Wansbeck General Hospital, Ashington, United Kingdom




                                                              the Kirschner wires at week 3.
                                                              Conclusion. The infection rate after percutaneous
ABSTRACT                                                      Kirschner wire fixation is unacceptable. Kirschner
                                                              wires should be buried under the skin to decrease the
Purpose. To review the infection rate in 43 patients          infection rate.
who underwent percutaneous Kirschner wire fixation
for distal radius fractures.                                  Key words: bone wires; radius fractures; surgical wound
Methods. Records of 13 men and 30 women aged                  infection
25 to 86 (mean, 49) years who underwent closed
reduction and percutaneous Kirschner wire fixation
for unstable distal radius fractures were reviewed.           INTRODUCTION
Each fracture was fixed with 2 to 3 wires of 1.6-
mm diameter. Kirschner wires were left protruding             Extra-articular fractures are more common than intra-
through the skin for easy removal, with their ends            articular fractures of the distal radius.1 The techniques
bent outside the skin to prevent migration. Wounds            of closed reduction and percutaneous Kirschner wire
were cleaned and dressed with gauze and a plaster-            fixation vary, with Kirschner wires either passing
of-Paris cast was applied. The severity of the pin            through both the distal and proximal fragments,2 or
tract infection was graded according to the modified          being fixed intrafocally into the fracture itself.3 It is a
Oppenheim classification.                                     common practice to leave Kirschner wires protruding
Results. Nine (21%) of the patients developed pin             through the skin for easy removal. We reviewed
tract infection (3 grade 1, 3 grade 2, 2 grade 3, and one     the infection rate in 43 patients who underwent
grade 4). Three patients underwent early removal of           percutan
								
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