Kirschner wires (K-wires) are commonly used during hand surgical procedures. These pins are often left exposed (protruding from the skin) for ease of removal. Complications such as loosening, migration, or infection are not uncommon (ranging from 7-18% in current retrospective studies) and can compromise surgical outcome. This study evaluated the frequency of K-wire related complications.
All patients who had K-wires placed as part of their surgical procedure in the hand or wrist by one of 12 attending hand surgeons over a 6-month period were enrolled prospectively. Complications were recorded by the attending surgeon at follow-up visits. Demographics and patient comorbidities including diabetes mellitus and smoking history were recorded.
There were 141 patients enrolled and 230 pins used, including 65 women and 76 men. The mean age was 40.7 years. Thirteen patients were smokers, and 8 had a history of diabetes. There were 35 soft tissue procedures and 106 fractures. There were 35 complications (25%). There was a 12% rate of infection (n=17) including 2 cases of osteomyelitis. There were 18 other complications 9 of which were major complications (6.4%). Smoking, age, and location (hand/fingers vs. wrist) were significantly associated with infection.
In this study, one in four patients treated with K-wires developed a minor or major complication, a rate which is substantially higher than reported in existing retrospective studies. While K-wires are often needed during hand surgery, surgeons should be aware that adverse events are frequent. Patients and surgeons should be vigilant in the peri-operative period.
1Rothman Institute, Department of Hand & Upper Extremity Surgery, 925 Chestnut Street, Philadelphia, PA 19107
Financial Disclosure Statement: The authors do not have any conflicts to disclose.
This study was reviewed and approved by an Institutional Review Board
Corresponding Author: Kevin F. Lutsky, MD, The Rothman Institute, 925 Chestnut St. 5th floor, Philadelphia, PA 19107, Kevin.firstname.lastname@example.org