Department of Orthopedic Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
Department of Preventive Medicine & Public Health, Catholic Kwandong University College of Medicine, Gangneung, Korea.
J Plast Surg Hand Surg. 2022 Feb;56(1):58-62. doi: 10.1080/2000656X.2021.1926272. Epub 2021 May 19.
Distal phalanx fractures are the most common injuries of the hand, and K-wire fixation is commonly performed for unstable fractures. However, there is no consensus regarding the number of K-wires to use in bone fixation. We aimed to compare the results between single and dual K-wire pinning. This retrospective study enrolled patients who underwent K-wire pinning for unstable distal phalanx fractures, including the shaft and tuft, from June 2016 through April 2020. We divided patients into two groups based on the number of K-wires used for bone fixation (single vs. dual). Clinical and radiographic data were measured and compared between the two groups. Additionally, multivariable logistic analysis was performed to identify the risk factors for nonunion. A total of 80 patients were enrolled. Among them, 27 were managed with a single K-wire and 53 with a dual K-wire. There was no significant difference in the union rate between the single and dual K-wire groups (77.7% vs. 84.9%, respectively), but time to union was significantly longer in the single K-wire group (11.3 vs. 8.4 weeks; = .003). The presence of a bone gap after fixation was a risk factor for nonunion. Our study showed that the union rate was comparable between single and dual K-wire pinning in distal phalanx fractures. However, dual K-wire pinning shortened the union time.
远节指骨骨折是手部最常见的损伤，对于不稳定骨折通常采用克氏针固定。然而，对于骨固定中使用的克氏针数量尚没有共识。我们旨在比较单枚和双枚克氏针固定的结果。本回顾性研究纳入了 2016 年 6 月至 2020 年 4 月期间因不稳定远节指骨骨折（包括骨干和趾骨）接受克氏针固定的患者。我们根据用于骨固定的克氏针数量（单枚 vs. 双枚）将患者分为两组。比较两组之间的临床和影像学数据。此外，还进行了多变量逻辑分析以确定骨不连的危险因素。共纳入 80 例患者。其中，27 例采用单枚克氏针治疗，53 例采用双枚克氏针治疗。单枚和双枚克氏针组的愈合率无显著差异（分别为 77.7%和 84.9%），但单枚克氏针组的愈合时间明显更长（11.3 周 vs. 8.4 周； = .003）。固定后存在骨间隙是骨不连的危险因素。我们的研究表明，在远节指骨骨折中，单枚和双枚克氏针固定的愈合率相当。然而，双枚克氏针固定可缩短愈合时间。
