Localizing retrograde K-wire insertion points in distal phalanges using the nail plate: a clinical controlled study.

Area of Science:

• Orthopedic surgery
• Hand surgery
• Traumatology

Background:

• Distal phalangeal fractures are common hand injuries.
• K-wire fixation is a frequent surgical treatment for these fractures.
• Accurate K-wire placement is crucial for optimal outcomes.

Purpose of the Study:

• To evaluate the efficacy of using nail plate shadows on preoperative X-rays for guiding retrograde K-wire fixation.
• To improve the accuracy of K-wire placement in distal phalangeal fractures.

Main Methods:

• A case-control study involving 60 patients with distal phalangeal fractures.
• Group A: K-wire fixation based on surgeon experience.
• Group B: K-wire fixation guided by measurements from preoperative X-rays (nail plate shadow, central axis).

Main Results:

• All fractures achieved healing and radiological union.
• No significant differences in DASH scores or distal interphalangeal (DIP) joint range of motion (ROM).
• Group B showed significantly lower VAS scores, shorter operation times, and reduced fluoroscopy times compared to Group A.

Conclusions:

• Utilizing the nail plate shadow on preoperative X-rays enhances the accuracy of retrograde K-wire fixation for distal phalanges.
• This technique reduces operation time and radiation exposure.
• It offers an improved approach compared to empirical K-wire placement.