K-wire Osteosynthesis of the Hand in the Outpatient Clinic: Assessment of the Infectious Risks

The aim of this project is to determine whether performing K-wire osteosynthesis of the hand in an outpatient clinic generates a higher rate of infections compared with those occurring after performing the same technique in an operating room.

We reviewed the electronic medical charts of 172 patients who underwent percutaneous pinning of the hand in our center's outpatient clinic during 2021 and 2022. Relevant data, including patient risk factors (eg, diabetes), procedural management (eg, number of days before pin removal), and outcomes were collected and analyzed. These results were then compared with infection rates reported in the current scientific literature for the same procedure performed in operating rooms.

Of the 172 patients studied, 12 infections occurred (7.0%), including 9 superficial infections (5.2%), such as cellulitis, and 3 deep infections (1.7%), such as osteomyelitis. Infectious complications were positively correlated with risk factors such as diabetes and index finger injuries.

Literature review indicates that infection rates for K-wire osteosynthesis in an operating room range from 2.0% to 21.4%, with an average risk of around 8.0%. The incidence of deep infections is estimated at 2.0%. Therefore, we conclude that infection rates for percutaneous pinning of the hand performed in outpatient clinics are comparable to those performed in operating rooms.