A Modified Method for Coverage of Kirschner Wire Ends

Abstract

The sharp ends of Kirschner wires are commonly covered with commercially available adhesive metal covers or other postsurgical covers to prevent damage to dressings, injury to patient, and migration into the body. We have found that these protectors tend to fall off when the dressings are removed, and have developed an alternative, using the silicone rubber seal from any size syringe, that does not slip off and would add no or very minimal cost to any surgical procedure.

The sharp ends of Kirschner (K) wires are commonly covered with commercially available adhesive metal covers or other postsurgical covers^1,2 to prevent damage to dressings, injury to patient, and migration into the body. We have found that these tend to dislodge when the dressings are removed and have developed an alternative, using the silicone rubber seal from any standard syringe. This adds negligible cost to the surgical procedure.

A stab incision made on one side of the seal allows the wire to be passed as shown in Figure 1. Any suture material is used to secure the K-wire to the compressible rubber surface. Because the rubber is compressible, a knot tying it to the wire is very secure. In Figure 1, the knot is tied over a straight K-wire, but we have found that if the K-wire is bent over within the seal, the construct is made stronger. This also prevents the construct from slipping from the K-wire, and importantly, stops the wire form migrating into the body.

FIGURE 1: Kirschner wire end covered with the seal from a 5-mL syringe, held in place with a 5/0 nylon suture.

The rubber seal is strong enough to be protective, and the construct is strong enough to survive repeated changes of dressing. If a syringe (for example, that used to administer local anesthetic) and suture have been used during the procedure, no additional materials are required. This construct takes less than a minute to create.