K-wire Made Easy by Premarking Wire Trajectory on the Skin in Management of Finger Fractures

Abstract

Background: Hand injury in general and fractures in particular are among the most common complaints of hand trauma patients presenting to our emergency department. Depending on fracture types, geometry, locations, and stability, treatment options may vary from close reduction and splinting to close reduction and K-wire fixation, and finally, to open reduction and internal fixation. The aim of the study was to prove that premarking of K-wire trajectory helps reduce procedure and fluoroscopy time, as well as the number of wire-insertion attempts, and minimize bone and soft tissue injury in the management of phalangeal finger fractures. Methods: This is a prospective descriptive study aimed to describe a surgical technique. Patients who underwent close reduction and K-wire fixation of phalangeal digital fractures were enrolled. A total of 20 cases were included. Results: The total number of K-wires was 37, and the total number of successful attempts was 40; average fluoroscopy time was 22.75 seconds; and average total operative time was 14.25 minutes. Surgeries of all cases were supervised by a consultant physician, but some were performed by a junior resident in the team. The inaccuracy index was measured for the group. Conclusions: Marking of the trajectory before placing K-wires for the management of digital fractures is not described in the literature. Our study describes an innovative operative technique that, when combined with the classic K-wire fixation technique, produces beneficial outcomes in the form of reduction in operative time and number of wire introduction attempts, with overall reduction in fluoroscopy time and soft tissue and bone damage (including false passages).