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KMID : 0621520150200010008
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Journal of the Korean Society for Surgery of the Hand
2015 Volume.20 No. 1 p.8 ~ p.14
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Manual Kirschner-Wire Insertion through the Soft Tissue for Finger Immobilization after Scar Contracture Release
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Lee Jun-Hee
Lee Kang-Woo
Burm Jin-Sik
Yang Won-Yong
Kang Sang-Yoon
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Abstract
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Purpose: Finger immobilization by Kirschner-wire (K-wire) insertion may be used for postoperative stability after release of scar contracture. K-wire insertion through the phalangeal bone requires drilling and can result in joint and/or tendon injury or pain during wire removal. To prevent these problems, we inserted the K-wire through the soft tissue.
Methods: Seventy-five fingers of 45 patients who underwent reconstruction of scar contracture of the fingers were immobilized by K-wire. After contracture release, just before skin grafting and/or local flap surgery, in full extension of the finger, a K-wire was inserted manually from the fingertip to the proximal phalanx or metacarpal bone through the soft tissue under the phalangeal bone, along the longitudinal axis on the volar side. If the graft site did not have enough soft tissue or the K-wire was felt on the recipient bed, the K-wire was inserted on the dorsal side of the finger. K-wires were manually removed two weeks after surgery.
Results: In most cases, the time to insert the K-wire was 2-3 minutes per finger, and immobilization and stability was maintained for two weeks. In two fingers, the K-wire came out prematurely during wound care; this did not affect the overall outcome. There were no complications due to K-wire insertion or pain during removal.
Conclusion: Finger immobilization by K-wire insertion through soft tissue is simple to perform, leads to stable immobilization, has no adding procedure. This method is useful for temporary finger immobilization in full extension.
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KEYWORD
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Finger, Immobilization, Kirschner wire, Soft tissue, Contracture release
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