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Kirschner wire

Intraoperative X-Ray of aHumerus fixated by Kirschner

wires

Kirschner wires or K-wires or pins are sterilized, sharpened, smooth stainless steel

pins. Introduced in 1909 by Martin Kirschner, the wires are now widely used in

orthopaedics and other types of medical and  veterinary surgery. They come in

different sizes and are used to hold bone fragments together (pin fixation) or to

provide an anchor for skeletal traction. The pins are often driven into the bone

through the skin (percutaneous pin fixation) using a power or hand drill. They also

form part of the Ilizarov apparatus.

Kirschner Wires used for fixationof a Colles' fracture

Variations

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Threaded K-wires are manufactured. They are used in situations where backing out

of the pin is undesirable but they are weaker.

"Denham Pins" are strong stout wires with a threaded portion in the middle. They

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Indications

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Complications

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References

are used for skeletal traction with the threads engaging the bone.

K-wires are used for temporary fixation during some operations. After

definitive fixation they are then removed.

They can be used for definitive fixation if the fracture fragments are small

(e.g. wrist fractures and hand injuries). In some settings they can be used for

intramedullary fixation of bones such as the  ulna.

Tension band wiring is a technique in which the bone fragments are

transfixed by K-wires which are then also used as an anchor for a loop of flexible wire. As the loop is tightened the bone fragments are compressed

together. Fractures of the kneecap and the  olecranon process of the elbow

are commonly treated by this method.

A wire is passed through the skin then transversely through the bone and out

the other side of the limb. The wire is then attached to some form of traction

so that the pull is applied directly to bone.

They can be used for temporary joint immobilization.

Pin tract infection: Because K-wires often pass through the skin into bone

they form a potential passage for bacteria from the skin to migrate into the

bone and cause an infection. In such cases, the area around the pinbecomes red and swollen and may start to drain pus. Usually this infection

clears up after removal of the pin.

Breakage: K-wires may bend or break, especially if the fracture does not

heal.[1]

Loss of fixation: Smooth K-wires may back out of the bone losing the

fixation. This is especially likely if they pass between two mobile bones.

Migration of K-wires can occur; instead of backing out the wire can move

deeper. K-wires passed across the acromioclavicular (AC) joint in the

shoulder have been found to migrate into the chest with the potential to

penetrate the major blood vessels, the trachea[2]

, lung[3]

, or the heart[4]

.

^ Cebesoy O, Subasi M, Arpacioglu O (August 2007). "Finsen V, Hofstad M,

Haugan H. A rare complication in scaphoid pseudoarthrosis: intraarticlar

1.

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External links

migration and breaking of Kirschner wire". Injury 38 (8): 988–9.

doi:10.1016/j.injury.2007.04.011   . PMID 17631883   .

^ Mitsuo Nakayama, MD, PhD*, Masatoshi Gika, MD, PhD, Hiroki Fukuda, MD,

Takeshi Yamahata, MD, Kohei Aoki, MD, Syugo Shiba, MD, Keisuke Eguchi,

MD, PhD (2009). "Migration of a Kirschner Wire From the Clavicle Into the

Intrathoracic Trachea"   . Ann Thorac Surg  88 (2): 653–654.

doi:10.1016/j.athoracsur.2008.12.093   . PMID 19632433   . Retrieved

2009-12-15.

2.

^ Robert Mazet Jr. (1943). "Migration of a Kirschner Wire From the

Shoulder Region Into the Lung:Report of Two Cases"   . Journal of Bone and

Joint Surgery 25 (2): 477–483. Retrieved 2009-12-15.

3.

^ Lenard L, Aradi D, Donauer E. (April 2009).  "Migrating Kirschner wire in

the heart mimics acute coronary syndrome"   . Eur Heart J  30 (7): 754.

doi:10.1093/eurheartj/ehn548   . PMID 19066210   . Retrieved 2009-12-15.

4.

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