Hoffmann Sebastian, Müller Amelie, Illg Claudius, Daigeler Adrien, Held Manuel, Thiel Johannes Tobias
BG Klinik Tübingen, Tübingen, Germany.
Arch Orthop Trauma Surg. 2025 May 3;145(1):280. doi: 10.1007/s00402-025-05900-1.
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.
在这项随机前瞻性试验中，我们比较了用于近端指骨骨折的克氏针骨固定技术。在2021年4月至2024年2月期间，图宾根BG创伤中心治疗的28例患者被分为两组。两组均采用两根克氏针进行骨固定：A组，克氏针末端留在皮外，而B组，克氏针末端埋于皮下。随访显示，与皮外克氏针（45.46%）相比，皮下克氏针的感染率显著降低（5.89%）。术后感染发生在术后前6周内。两名患者不得不意外地接受手术翻修以更换或移除克氏针。此外，A组近端指间关节的总主动活动范围比B组少21.85°。患者也表示更喜欢将克氏针末端置于皮下。这些发现有力地支持了近端指骨骨折骨固定术后将克氏针末端埋入皮下。
