Percutaneous fixation of hand fractures using locked K-wires: mechanical analysis and clinical application

Closed percutaneous wire fixation of hand fractures frequently requires protection with external splintage. This splintage increases the risk of joint stiffness, prolongs recovery time, and increases therapy input. We have developed a method of linking external Kirschner wires (K-wires), using a metal clamp, after their insertion, so as to increase the security of fixation and facilitate postoperative mobilization. The mechanical properties of this method have been assessed in vitro and compared with conventionally fixed, unlinked, K-wires. We have been able to establish that the linked K-wire system is better able to resist loosening. This work proposes that linkage of K-wires permits omission of all additional external splintage, with no detriment to management. The technique has been applied in clinical cases over the past 8 years and results of treatments were evaluated mainly to detect unexpected complications. We report a low rate of complications and good results in terms of bone healing and recovery of function.