Analysis of Bone Fixation Methods in Digital Replantation

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Microsurgery

Background:

• Digital replantation requires stable bone fixation for optimal healing and function.
• Various methods exist, including Kirschner (K-) wires and intraosseous wires.
• Assessing fixation techniques is crucial for improving replantation outcomes.

Purpose of the Study:

• To compare clinical and radiographic outcomes of different bone fixation methods in digital replantation.
• To evaluate the association between fixation techniques and bone union rates.
• To identify optimal fixation strategies for successful digital replantation.

Main Methods:

• Retrospective review of 103 digital replantations in 88 patients (July 2009-September 2015).
• Exclusion of distal phalanx, comminuted, and intra-articular fractures.
• Classification into 5 fixation groups: single K-wire, double longitudinal K-wires, cross K-wires, wire with K-wire support, and wire without K-wire support.

Main Results:

• Nonunion occurred in 31.1% of cases, with 13 requiring further surgery.
• Cross fixation showed the highest nonunion rate (35.7%).
• Wire alone fixation had the lowest nonunion rate (25.0%).

Conclusions:

• Single K-wire fixation demonstrated comparable outcomes to other methods, challenging existing assumptions.
• Careful selection of bone fixation techniques is key to achieving successful bone union.
• Findings offer valuable guidance for surgical planning in digital replantation procedures.