Temporary Kirschner wire ankle transfixation in the treatment of unstable ankle fractures

Seibert, F. J.; Schatz, B.; Bratschitsch, G.; Labovitz, Jonathan M.; Schippinger, G.

doi:10.1046/j.1460-9584.2001.00249.x

Cited by 5 publications

(18 citation statements)

References 13 publications

(12 reference statements)

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“…Additionally, removal of the broken wire is facilitated, if the ventral cortex of the tibia is perforated, providing easy access to the tibial wire. In accordance with Seibert et al [12], we are convinced that diameter and number of the wires used are crucial. Seibert et al reported one redislocation with wires < 2 mm in diameter.…”

Section: Discussionsupporting

confidence: 90%

“…K-wire transfixation proves to be an effective and safe alternative for temporary stabilization of ankle fractures [11,12]. Retention of reduction is reliable; we observed no redislocation in our series, and the morbidity of the procedure is low.…”

Section: Discussionsupporting

confidence: 51%

“…Skin care and continued assessment of soft tissue are facilitated without risking further damage. Exceptionally and under special circumstances, K-wire transfixation can even be considered being a definitive treatment modality in combination with a plaster cast (patient not fit for surgery, persistent skin lesions) [11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

“…Anatomic reduction is not the aim when ankle transfixation is performed [12]. Restoration of the normal relationship between tibia and talus is important.…”

Section: Discussionmentioning

confidence: 99%

“…Prolonged and forceful maneuvers bear the risk of causing even more damage to already compromised skin and soft tissues. Unlike Seibert et al [12], we do not routinely drill the K-wires through the ventral cortex of the tibia. We do not think that this detail is important, if transfixation is intended to be only temporary.…”

Section: Discussionmentioning

confidence: 99%

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Temporary Kirschner Wire Ankle Transfixation and Delayed ORIF

Meier¹,

Schefold²,

Hug³

et al. 2004

Eur J Trauma

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European Journal of TraumaAb stract Background and Purpose: Immediate ORIF (open reduction and internal fixation) is the treatment of choice for displaced ankle fractures. However, definitive treatment may have to be delayed due to compromised soft tissues. The value of temporary Kirschner wire ankle transfixation with staged ORIF for closed displaced ankle fractures with tibiotalar dislocations was determined.Patients and Methods: In this retrospective case series (1997)(1998)(1999)(2000)(2001), 92 patients (mean age 54 years, range 20-86 years) who underwent a staged procedure for isolated and closed displaced ankle fractures with tibiotalar dislocations were studied. Patients were primarily treated by means of immediate closed reduction. For stable fractures and adequate soft tissues a split plaster cast was applied (n = 50). K-wire transfixation was performed for unstable fracture-dislocations and/or critical soft tissues (n = 42). All patients underwent delayed ORIF after recovery of the soft tissues.Results: In the K-wire group (KWG), local complication rate was 7%. Mean operating time was 30 min (5-65 min). In the plaster cast group (PCG), local complication rate was 10% (p = 0.72, not significant). Three redislocated ankles (6%) had to be transfixed secondarily. A higher grade of soft-tissue injuries in the KWG (p < 0.05) resulted in a longer time interval between primary treatment and staged ORIF (7 vs. 5 days; p < 0.05) and a longer hospital stay (19 vs. 17 days; p < 0.05) for the KWG.Conclusion: Temporary K-wire ankle transfixation is an effective method for initial treatment of closed displaced ankle fractures with tibiotalar dislocation, if ORIF has to be delayed and immobilization in a split plaster cast is not suitable. Retention is reliable with a low complication rate.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

“…Anatomic reduction is not the aim when ankle transfixation is performed [12]. Restoration of the normal relationship between tibia and talus is important.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Temporary Kirschner Wire Ankle Transfixation and Delayed ORIF

Meier¹,

Schefold²,

Hug³

et al. 2004

Eur J Trauma

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Temporary Transarticular K-wire Fixation of Critical Ankle Injuries at Risk: A Neglected “Damage Control” Strategy?

Friedman¹,

Ly²,

Mauffrey³

et al. 2015

Orthopedics

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High-energy ankle fracture-dislocations are at significant risk for postoperative complications. Closed reduction and temporary percutaneous transarticular K-wire fixation was first described more than 50 years ago. This simple and effective "damage control" strategy is widely practiced in Europe, yet appears largely forgotten and abandoned in the United States. Anecdotal opposing arguments include the notion that drilling K-wires through articular cartilage may damage the joint and contribute to postinjury arthritis. This article describes the experience in a US academic level I trauma center with transarticular pinning of selected critical ankle fracture-dislocations followed by delayed definitive fracture fixation once the soft tissues are healed. Median patient follow-up of 2 years showed that the transarticular pinning technique was performed safely, not associated with increased postoperative complication rates, and characterized by good subjective outcomes using the American Academy of Orthopaedic Surgeons Foot and Ankle Outcome Score questionnaire.

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Kirschner Wire Transfixation of Unstable Ankle Fractures: Indication, Surgical Technique and Outcomes

Marvan¹,

Džupa²,

Bartoška³

et al. 2015

Acta Chir. orthop. Traum. Cech.

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PURPOSE OF THE STUDYThe aim of the study was to assess treatment outcomes in patients undergoing K-wire transfixation of unstable ankle fractures and compare the results with those of patients in whom it was possible to perform primary one-stage osteosynthesis. MATERIAL AND METHODSBetween 2009 and 2012, a total of 358 patients (191 women and 167 men) had surgery for unstable ankle fracture. At 1-year follow-up, their subjective feelings, objective findings and ankle radiographs were evaluated. The fractures were categorised according to the Weber classification. A patient group treated by one-stage osteosynthesis, a group with definitive transfixation and a group of patients in whom temporary transfixation was converted to definitive osteosynthesis were assessed and compared. RESULTSThe group treated by one-stage osteosynthesis included 278 patients with an average age of 47 years; the group of 20 patients with definitive transfixation had an average age of 67 years, and the group of 60 patients who had temporary transfixation with subsequent conversion to internal osteosynthesis were 55 years on average. In the group with one-stage osteosynthesis, 223 (80%) ankle fractures on post-injury radiographs were associated with minor joint dislocations and 55 (20%) with major dislocations. On the other hand, the radiographs of the patients treated by temporary transfixation and delayed open reduction with internal fixation showed major dislocations in 38 (63%) and minor dislocations in the rest of the patients (37%); the difference between the two groups was statistically significant (p<0.001). Posterior malleolar fractures were most frequent in the group with temporary transfixation (60%) and least frequent in the group with primary osteosynthesis (44%); also this difference was statistically significant (p=0.032).At one-year follow-up, in the group with one-stage osteosynthesis, 220 patients (79%) had no radiographic signs of posttraumatic ankle osteoarthritis while, in the group with temporary transfixation, no radiographic evidence of ankle osteoarthritis was recorded in 25 (42%) patients. While tibiofibular synostosis was recorded in only few patients (9%) of the group with one-stage osteosynthesis, it showed a high occurrence in the group with temporary transfixation (35%). The patients with one-stage osteosynthesis (188/68%) had a higher proportion of excellent outcomes measured on the Olerund-Molander ankle scoring scale than the other two groups (temporary transfixation, 47%; definitive transfixation,10%); in both cases the difference was significant (p < 0.001 and p = 0.003, respectively). DISCUSSIONIn this study the morphological and clinical aspects of surgically treated ankle fractures were assessed. The patients with one-stage osteosynthesis were compared with those treated by temporary or definitive transfixation. The majority of patients undergoing temporary transfixation had a fractured posterior margin of the tibia and major ankle joint dislocation, which suggested serious injuries to bone and ligament...

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Temporary Kirschner wire ankle transfixation in the treatment of unstable ankle fractures

Cited by 5 publications

References 13 publications

Temporary Kirschner Wire Ankle Transfixation and Delayed ORIF

Temporary Kirschner Wire Ankle Transfixation and Delayed ORIF

Temporary Transarticular K-wire Fixation of Critical Ankle Injuries at Risk: A Neglected “Damage Control” Strategy?

Kirschner Wire Transfixation of Unstable Ankle Fractures: Indication, Surgical Technique and Outcomes

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