Arch Hand Microsurg.  2021 Sep;26(3):171-173. 10.12790/ahm.21.0114.

Broken Kirschner Wire in Distal Interphalangeal Joint Fixation: A Case Report

• Lee KJ
• Park JH
• Koh SH
• Lee DC
• Roh SY
• Kim JS

• KMID: 2519470
• DOI: http://doi.org/10.12790/ahm.21.0114

Abstract

Kirschner wire (K-wire) has been widely used for treatment of fracture for its cost-effectiveness and reliability. This case presents the K-wire breakage in distal interphalangeal joint (DIPJ) fixation. A 55-year-old male patient was injured by a knife and showed rupture of extensor tendon at 1/2 of middle phalanx. A 0.9-mm K-wire was implemented for DIPJ extension, and tenorrhaphy was done. After 6 weeks, we detected breakage of K-wire in the follow-up X-ray. The broken K-wire in the distal phalanx was removed. We removed the remaining K-wire through an incision on volar side of middle phalanx under C-arm after 2 weeks for the patient’s personal reasons. Breakage during postoperative K-wire maintenance is exceedingly rare. This patient is presumed to have ruptured because he continued using his finger. Therefore, while K-wire is present, continued use of finger without protection may cause breakage, so protective measures such as splint are required.

Keyword

Bone wires; Equipment failure; Fingers

Figure

• 

  Fig. 1. (A) 55-years-old male patient presented distal interphalangeal joint subluxation and rupture of extensor digitorum. (B) Single Kirschner wire fixation and extensor tenorrhaphy.

• 

  Fig. 2. (A) Broken Kirschner wire (K-wire) found on 6-week postoperative X-ray. (B) Removal of distal part of K-wire at outpatient department.

• 

  Fig. 3. Removal of retained proximal part of Kirschner wire at operation room.

Reference

1. Black D, Mann RJ, Constine R, Daniels AU. Comparison of internal fixation techniques in metacarpal fractures. J Hand Surg Am. 1985; 10:466–72.

2. Botte MJ, Davis JL, Rose BA, et al. Complications of smooth pin fixation of fractures and dislocations in the hand and wrist. Clin Orthop Relat Res. 1992; (276):194–201.

3. Hong SJ, Lee HJ, Kim JY, Eo SR, Cho SH. K-wire breakage during metalware removal due to a defective k-wire shaft. Arch Plast Surg. 2013; 40:655–7.

4. Pichler W, Mazzurana P, Clement H, Grechenig S, Mauschitz R, Grechenig W. Frequency of instrument breakage during orthopaedic procedures and its effects on patients. J Bone Joint Surg Am. 2008; 90:2652–4.

5. Stahl S, Schwartz O. Complications of K-wire fixation of fractures and dislocations in the hand and wrist. Arch Orthop Trauma Surg. 2001; 121:527–30.

6. Zingas C, Katcherian DA, Wu KK. Kirschner wire breakage after surgery of the lesser toes. Foot Ankle Int. 1995; 16:504–9.

7. Wong KY, Mole R, Gillespie P. Kirschner wire breakage during removal requiring retrieval. Case Rep Surg. 2016; 2016:7515760.