Kirschner Wire Breakage during Removal Requiring Retrieval.

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Trauma Management

Background:

• Kirschner wires (K-wires) are common for hand fracture fixation due to availability and cost-effectiveness.
• Complication rates for K-wire fixation can reach 18%, with pin site infections reported up to 7%.

Purpose of the Study:

• To present a rare case of K-wire breakage during removal after open fracture fixation.
• To illustrate a simple, novel technique for retrieving a retained K-wire fragment.
• To highlight potential complications of K-wire fixation in hand surgery.

Main Methods:

• A 35-year-old male with an open distal phalanx fracture of the middle finger underwent K-wire fixation.
• Postoperative pin site infection and swelling occurred, leading to K-wire removal.
• A novel surgical technique was employed to retrieve the broken K-wire fragment retained in the phalanx.

Main Results:

• The K-wire fractured during removal, with the proximal piece retained in the middle phalanx.
• The novel retrieval technique was successful in removing the fragment.
• The patient achieved full return of hand function with no signs of osteomyelitis.

Conclusions:

• K-wire breakage during removal, though rare (0.1% intraoperative rate), can occur without obvious cause.
• Pin site infections are a more common complication associated with K-wire fixation.
• Awareness of potential K-wire complications and effective retrieval techniques is crucial for optimal patient outcomes in hand surgery.