Zingas C, Katcherian D A, Wu K K
Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan, USA.
Foot Ankle Int. 1995 Aug;16(8):504-9. doi: 10.1177/107110079501600809.
A retrospective review was made of all patients operated on by the two senior authors from January 1985 to January 1993 for problems with Kirschner wire breakage following forefoot surgery. Thirty-three broken K-wires in 27 patients were encountered. All of these were 0.045-inch K-wires that had been placed across the metatarsophalangeal (MTP) joint of the lesser toes. In no case was there breakage of a K-wire that was larger than 0.045 inches or that did not cross the MTP joint. The medical records and radiographs of 565 consecutive patients having fixation with 0.045-inch K-wires that crossed the MTP joints of the lesser toes were then reviewed. A total of 1002 K-wires were used with an overall failure rate of 3.2% (4.8% of the patients). All of these K-wires failed just proximal to the point of entry into the metatarsal head. No intra-articular retained fragments were noted. Twenty-five of the retained fragments were completely within the metatarsal head and shaft, and eight of these fragments pierced the cortex of the metatarsal proximally. Twenty-three patients with retained fragments were examined in follow-up and in no case could the retained fragment be palpated or directly related to postoperative symptoms. Of the three patients who complained of persistent pain, two had mild pain with persistent MTP synovitis and one had severe pain due to lateral deviation of the toe after surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
对1985年1月至1993年1月期间由两位资深作者进行手术的所有患者进行了回顾性研究，这些患者因前足手术后克氏针断裂问题接受治疗。共遇到27例患者的33根克氏针断裂。所有这些都是0.045英寸的克氏针，放置在小趾的跖趾关节处。没有出现大于0.045英寸或未穿过跖趾关节的克氏针断裂情况。然后回顾了565例连续使用0.045英寸克氏针固定小趾跖趾关节患者的病历和X线片。共使用了1002根克氏针，总体失败率为3.2%（患者的4.8%）。所有这些克氏针均在进入跖骨头的近端处断裂。未发现关节内残留碎片。25个残留碎片完全位于跖骨头和骨干内，其中8个碎片近端穿透了跖骨皮质。对23例有残留碎片的患者进行了随访检查，未发现残留碎片可触及或与术后症状直接相关。在3例主诉持续疼痛的患者中，2例因持续性跖趾滑膜炎有轻度疼痛，1例因术后脚趾外侧偏斜有严重疼痛。（摘要截断于250字）
