Desai Aravind, Dramis Asterios, Thompson Neville, Board Tim, Choudhary Awani
Bassetlaw District General Hospital, Worksop, United Kingdom.
Acta Orthop Belg. 2009 Jun;75(3):310-5.
The aim of this study was to find out whether discharging pin sites following Kirschner-wire fixation of distal radial fractures warrant early wire removal. In a prospective study of 50 patients with a closed distal radial fracture treated by manipulation and either percutaneous or mini-incision Kirschner-wiring, we identified 14 patients (28%) with discharging pin sites. All of the cases were observed within the first two weeks following surgery. Of the 14 cases, only 2 patients had a positive swab culture and were treated with systemic antibiotics. In all cases the Kirschner wires were left in situ until serial radiographs demonstrated satisfactory union. Three patients (8.6%) in the percutaneous group had superficial radial nerve irritation, which settled following wire removal. Deep soft tissue infection, pyoarthrosis, osteomyelitis, and extensor tendon rupture were not encountered. We conclude that pin site discharge, whether sterile or infected, is in general not an indication for early wire removal.
本研究的目的是确定桡骨远端骨折克氏针固定后针道引流是否需要早期拔除克氏针。在一项对50例闭合性桡骨远端骨折患者进行的前瞻性研究中，这些患者通过手法复位以及经皮或小切口克氏针内固定治疗，我们发现14例（28%）患者存在针道引流。所有病例均在术后两周内进行观察。在这14例病例中，只有2例患者拭子培养呈阳性，并接受了全身抗生素治疗。在所有病例中，克氏针均保留原位，直至系列X线片显示骨折愈合满意。经皮组有3例患者（8.6%）出现桡神经浅支刺激症状，拔除克氏针后症状缓解。未发生深部软组织感染、化脓性关节炎、骨髓炎和伸肌腱断裂。我们得出结论，针道引流，无论无菌或感染，一般都不是早期拔除克氏针的指征。
