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Kirschner-wire fixation for postburn flexion contracture deformity and consequences on articular surface
Nezih Sungur1, Mustafa Gürhan Ulusoy, Süreyya Boyacgil
1Plastic and Reconstructive Surgery Department, Ankara Training and Research Hospital, Ankara, Turkey.
Annals of Plastic Surgery
|January 25, 2006
Summary
Kirschner-wire (K-wire) fixation effectively stabilizes fingers after contracture release without causing permanent joint damage. This method aids in preventing deformity recurrence and secures skin grafts, offering satisfactory functional and aesthetic outcomes.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Musculoskeletal Imaging
Background:
- Flexion contracture deformities of the hand fingers require effective stabilization post-surgical release.
- Kirschner-wire (K-wire) fixation is a common method, but concerns exist regarding potential articular surface damage in small joints.
- Existing literature presents conflicting reports on the long-term effects of K-wire fixation on joint integrity.
Purpose of the Study:
- To prospectively evaluate the safety and efficacy of K-wire fixation for finger joint stabilization after flexion contracture release.
- To investigate the incidence of permanent articular surface damage following K-wire fixation in interphalangeal (IP) and metacarpophalangeal (MCP) joints.
- To assess the clinical and radiological outcomes of K-wire fixation in patients with hand flexion contractures.
Main Methods:
- A prospective study involving 72 patients undergoing surgical release of finger flexion contractures.
- Immobilization of IP and MCP joints using K-wire fixation for 3 weeks.
- Clinical assessment included Total Active Motion (TAM), grip, and pinch force measurements.
- Radiological assessment utilized Magnetic Resonance (MR) and radionuclide imaging.
- Mean follow-up period was 32 months.
Main Results:
- Satisfactory functional and aesthetic results were achieved in the patient cohort.
- Clinical and radiological evaluations demonstrated no evidence of permanent articular surface damage.
- K-wire fixation proved effective in preventing contracture recurrence.
- The technique successfully stabilized skin grafts in relevant cases.
Conclusions:
- K-wire fixation is a safe and effective method for stabilizing fingers after flexion contracture release.
- The procedure does not lead to permanent articular surface damage in the treated small joints.
- K-wire fixation is an invaluable approach for preventing recurrence and ensuring graft stability, yielding positive functional outcomes.