Longer time of implantation using the buried pin technique for intramedullary nailing would decrease refracture in the diaphyseal forearm fracture in children-retrospective multicenter (TRON) study

Ohshima, Kazuma; Tokutake, Katsuhiro; Takegami, Yasuhiko; Asami, Yuta; Matsubara, Yumiko; Natsume, Tadahiro; Kimura, Yoshihiko; Ishihara, Noriko; Imagama, Shiro

doi:10.1016/j.injury.2023.01.025

Cited by 3 publications

(1 citation statement)

References 24 publications

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“…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.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

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

Hidajat,

Magetsari,

Prasetiyo

et al. 2024

PLoS ONE

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Background The recommendation on whether to bury or expose the Kirschner wire (K-wire) for the management of fractures has still been controversial with inconsistent results in the published studies due to the potential issue associated with exposed K-wire is the heightened risk of infection, as it comes into direct contact with the external environment and air. This study aims to summarize the specific outcomes between buried and exposed K-wire for the management of hand and forearm fractures. Methods We conducted relevant literature searches on Europe PMC, Medline, Scopus, and Cochrane Library databases using specific keywords. This investigation focuses on individuals of any age diagnosed with hand or forearm fractures who underwent surgery involving Kirschner wire (K-wire) fixation. It examines the comparison between buried and exposed K-wire fixation, emphasizing primary outcome pin infection, along with secondary outcomes such as early pin removal, days to pin removal, and surgical duration. The study includes observational studies (cohort/case-control) or randomized clinical trials (RCTs). The results of continuous variables were pooled into the standardized mean difference (SMD), while dichotomous variables were pooled into odds ratio (OR) along with 95% confidence intervals using random-effect models. The quality of included studies was assessed with Cochrane Collaborations, Risk of Bias version 2 (RoB v2). Results A total of 11 studies were included. Our pooled analysis revealed that buried K-wire was associated with a lower risk of pin site infection [RR 0.49 (95% CI 0.36–0.67), p < 0.00001, I2 = 0%] and 33.85 days longer duration until pin removal [MD 33.85 days (95% CI 18.68–49.02), p < 0.0001, I2 = 99%] when compared with exposed K-wire. However, the duration of surgery was 9.98 minutes significantly longer in the buried K-wire [MD 6.98 minutes (95% CI 2.19–11.76), p = 0.004, I2 = 42%] with no significant difference in the early pin removal rate [RR 0.73 (95% CI 0.36–1.45), p = 0.37, I2 = 0%]. Further regression analysis revealed that sample size, age, sex, and duration of follow-up did not affect those relationships. Conclusion Buried K-wire may offer benefits in reducing the infection rate with a longer duration until pin removal. However, further RCTs with larger sample sizes are still needed to confirm the results of our study.

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Section: Study Selection and Characteristicsmentioning

confidence: 99%

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

Hidajat,

Magetsari,

Prasetiyo

et al. 2024

PLoS ONE

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An age-matched comparative study on intramedullary nailing and plate fixation of both-bone diaphyseal forearm fracture in adolescents

Ishihara

Tokutake

Takegami

et al. 2023

Eur J Orthop Surg Traumatol

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

Hidajat,

Magetsari,

Prasetiyo

et al. 2023

Preprint

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BackgroundThe recommendation on whether to bury or expose the Kirschner wire (K-wire) for the management of fractures has still been controversial with inconsistent results in the published studies. This study aims to summarize the comparison between buried and exposed K-wire for the management of hand and forearm fractures.MethodsWe conducted relevant literature searches on Europe PMC, Medline, Scopus, and Cochrane Library databases using specific keywords. The results of continuous variables were pooled into the standardized mean difference (SMD), while dichotomous variables were pooled into odds ratio (OR) along with 95% confidence intervals (95% CI) using random-effect models.ResultsA total of 11 studies were included. Our pooled analysis revealed that buried K-wire was associated with a lower risk of pin site infection [RR 0.49 (95% CI 0.36 – 0.67),p< 0.00001,I2= 0%] and longer duration until pin removal [MD 33.85 days (95% CI 18.68 – 49.02),p< 0.0001,I2= 99%] when compared with exposed K-wire. However, the duration of surgery was significantly longer in the buried K-wire [MD 6.98 minutes (95% CI 2.19 – 11.76),p= 0.004,I2= 42%] with no significant difference in the early pin removal rate [RR 0.73 (95% CI 0.36 – 1.45),p= 0.37,I2= 0%]. Further regression analysis revealed that sample size, age, sex, and duration of follow-up did not affect those relationships.ConclusionBuried K-wire may offer benefits in reducing the infection rate with a longer duration until pin removal. However, further RCTs with larger sample sizes are still needed to confirm the results of our study.

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Longer time of implantation using the buried pin technique for intramedullary nailing would decrease refracture in the diaphyseal forearm fracture in children-retrospective multicenter (TRON) study

Cited by 3 publications

References 24 publications

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

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

An age-matched comparative study on intramedullary nailing and plate fixation of both-bone diaphyseal forearm fracture in adolescents

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

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