Subcutaneous vs. transcutaneous K-wires for proximal phalanx fractures: a prospective randomized trial on infection rates

IF 2 3区医学 Q2 ORTHOPEDICS

Archives of Orthopaedic and Trauma Surgery Pub Date : 2025-05-03 DOI:10.1007/s00402-025-05900-1

Sebastian Hoffmann, Amelie Müller, Claudius Illg, Adrien Daigeler, Manuel Held, Johannes Tobias Thiel

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Abstract

In this randomized prospective trial, we compared K-wire osteosynthesis techniques for fractures of the proximal phalanx. Between April 2021 and February 2024, 28 patients treated at the BG Trauma Center Tuebingen were divided into two groups. Both groups underwent osteosynthesis with two K-wires: in Group A, the wire ends were left transcutaneous, while in Group B, they were buried subcutaneously. Follow-up revealed a significantly lower infection rate with subcutaneous wires (5.89%) compared to transcutaneous wires (45.46%). The postoperative infection occurred within the first 6 weeks after surgery. Two patients had to undergo surgical revision changing or removing the K-wires unexpectedly. Additionally, the total active range of motion of the PIP joint in Group A was 21.85° less than in Group B. Patients also expressed a preference for subcutaneous placement of wire ends. These findings strongly support burying K-wire ends after osteosynthesis of proximal phalanx fractures.

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近端指骨骨折的皮下与经皮k针治疗：感染率的前瞻性随机试验

在这项随机前瞻性试验中，我们比较了近端指骨骨折的k -钢丝接骨技术。在2021年4月至2024年2月期间，28名在图宾根BG创伤中心接受治疗的患者被分为两组。两组均采用两根克氏针进行骨固定：A组克氏针末端经皮保留，B组克氏针末端皮下埋置。随访发现，皮下针组感染率（5.89%）明显低于经皮针组（45.46%）。术后感染发生在术后6周内。2名患者意外地接受了手术修复、更换或移除k针。此外，A组PIP关节的总活动范围比b组小21.85°。患者也表示倾向于皮下放置金属丝末端。这些发现有力地支持近端指骨骨折接骨后埋设k线。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Orthopaedic and Trauma Surgery 医学-外科

CiteScore

4.30

自引率

13.00%

发文量

424

审稿时长

2 months

期刊介绍： "Archives of Orthopaedic and Trauma Surgery" is a rich source of instruction and information for physicians in clinical practice and research in the extensive field of orthopaedics and traumatology. The journal publishes papers that deal with diseases and injuries of the musculoskeletal system from all fields and aspects of medicine. The journal is particularly interested in papers that satisfy the information needs of orthopaedic clinicians and practitioners. The journal places special emphasis on clinical relevance. "Archives of Orthopaedic and Trauma Surgery" is the official journal of the German Speaking Arthroscopy Association (AGA).