Buried versus exposed Kirschner wires following fixation of metacarpal and phalangeal fractures: a national clinician and patient survey
<h4>Background</h4> <p>Fractures of the metacarpals and phalanges are common. Placement of Kirschner wires (K-wires) is the most common form of surgical fixation. After placement, a key decision is whether to bury the end of a K-wire or leave it protruding from the skin (exposed)....
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Journal article |
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Lippincott, Williams and Wilkins
2018
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| _version_ | 1826269655072768000 |
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| author | Gardiner, M Gardiner, S Issa, F Jain, A Lloyd-Hughes, H Pezas, T Rodrigues, J Wormald, J Acquaah, F Brierley, N Bickerton, S Chow, W Clutton, J Coulson, S Crowley, P Edmondson, S Fowler, A Gallagher, M Howles, S Jones, J Khan, L Kulendran, D Langley, C Manton, R Mohamed, M Ng, L Salibi, A Sameer, G Segaren, N Sharma, K Shiatis, A Steele, K Jay-Stewart, C Suwiton, C Tam, A Thind, A Wade, R Wielogorska, N Young, K |
| author_facet | Gardiner, M Gardiner, S Issa, F Jain, A Lloyd-Hughes, H Pezas, T Rodrigues, J Wormald, J Acquaah, F Brierley, N Bickerton, S Chow, W Clutton, J Coulson, S Crowley, P Edmondson, S Fowler, A Gallagher, M Howles, S Jones, J Khan, L Kulendran, D Langley, C Manton, R Mohamed, M Ng, L Salibi, A Sameer, G Segaren, N Sharma, K Shiatis, A Steele, K Jay-Stewart, C Suwiton, C Tam, A Thind, A Wade, R Wielogorska, N Young, K |
| author_sort | Gardiner, M |
| collection | OXFORD |
| description | <h4>Background</h4> <p>Fractures of the metacarpals and phalanges are common. Placement of Kirschner wires (K-wires) is the most common form of surgical fixation. After placement, a key decision is whether to bury the end of a K-wire or leave it protruding from the skin (exposed). A recent systematic review found no evidence to support either approach. The aim of study was to investigate current clinical practice, understand the key factors influencing clinician decision-making, and explore patient preferences to inform the design of a randomized clinical trial.</p> <h4>Methods</h4> <p>The steering group developed surveys for hand surgeons, hand therapists, and patients. Following piloting, they were distributed across the United Kingdom hand surgery units using the Reconstructive Surgery Trials Network.</p> <h4>Results</h4> <p>A total of 423 hand surgeons, 187 hand therapists, and 187 patients completed the surveys. Plastic surgeons and junior surgical trainees preferred to leave K-wires not buried. Ease of removal correlated with a decision to leave wires exposed, whereas perceived risk of infection correlated with burying wires. Cost did not affect the decision. Hand therapists were primarily concerned about infection and patient-related outcomes. Patients were most concerned about wire-related problems and pain.</p> <h4>Conclusion</h4> <p>This national survey provides a new understanding of the use of Kwires to manage hand fractures in the United Kingdom. A number of nonevidencebased factors seem to influence the decision to bury or leave K-wires exposed. The choice has important clinical and health economic implications that justify a randomized controlled trial.</p> |
| first_indexed | 2024-03-06T21:28:27Z |
| format | Journal article |
| id | oxford-uuid:43e21d7b-1c0f-4fd1-9572-e1e3f8127219 |
| institution | University of Oxford |
| last_indexed | 2024-03-06T21:28:27Z |
| publishDate | 2018 |
| publisher | Lippincott, Williams and Wilkins |
| record_format | dspace |
| spelling | oxford-uuid:43e21d7b-1c0f-4fd1-9572-e1e3f81272192022-03-26T14:58:16ZBuried versus exposed Kirschner wires following fixation of metacarpal and phalangeal fractures: a national clinician and patient surveyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:43e21d7b-1c0f-4fd1-9572-e1e3f8127219Symplectic Elements at OxfordLippincott, Williams and Wilkins2018Gardiner, MGardiner, SIssa, FJain, ALloyd-Hughes, HPezas, TRodrigues, JWormald, JAcquaah, FBrierley, NBickerton, SChow, WClutton, JCoulson, SCrowley, PEdmondson, SFowler, AGallagher, MHowles, SJones, JKhan, LKulendran, DLangley, CManton, RMohamed, MNg, LSalibi, ASameer, GSegaren, NSharma, KShiatis, ASteele, KJay-Stewart, CSuwiton, CTam, AThind, AWade, RWielogorska, NYoung, K <h4>Background</h4> <p>Fractures of the metacarpals and phalanges are common. Placement of Kirschner wires (K-wires) is the most common form of surgical fixation. After placement, a key decision is whether to bury the end of a K-wire or leave it protruding from the skin (exposed). A recent systematic review found no evidence to support either approach. The aim of study was to investigate current clinical practice, understand the key factors influencing clinician decision-making, and explore patient preferences to inform the design of a randomized clinical trial.</p> <h4>Methods</h4> <p>The steering group developed surveys for hand surgeons, hand therapists, and patients. Following piloting, they were distributed across the United Kingdom hand surgery units using the Reconstructive Surgery Trials Network.</p> <h4>Results</h4> <p>A total of 423 hand surgeons, 187 hand therapists, and 187 patients completed the surveys. Plastic surgeons and junior surgical trainees preferred to leave K-wires not buried. Ease of removal correlated with a decision to leave wires exposed, whereas perceived risk of infection correlated with burying wires. Cost did not affect the decision. Hand therapists were primarily concerned about infection and patient-related outcomes. Patients were most concerned about wire-related problems and pain.</p> <h4>Conclusion</h4> <p>This national survey provides a new understanding of the use of Kwires to manage hand fractures in the United Kingdom. A number of nonevidencebased factors seem to influence the decision to bury or leave K-wires exposed. The choice has important clinical and health economic implications that justify a randomized controlled trial.</p> |
| spellingShingle | Gardiner, M Gardiner, S Issa, F Jain, A Lloyd-Hughes, H Pezas, T Rodrigues, J Wormald, J Acquaah, F Brierley, N Bickerton, S Chow, W Clutton, J Coulson, S Crowley, P Edmondson, S Fowler, A Gallagher, M Howles, S Jones, J Khan, L Kulendran, D Langley, C Manton, R Mohamed, M Ng, L Salibi, A Sameer, G Segaren, N Sharma, K Shiatis, A Steele, K Jay-Stewart, C Suwiton, C Tam, A Thind, A Wade, R Wielogorska, N Young, K Buried versus exposed Kirschner wires following fixation of metacarpal and phalangeal fractures: a national clinician and patient survey |
| title | Buried versus exposed Kirschner wires following fixation of metacarpal and phalangeal fractures: a national clinician and patient survey |
| title_full | Buried versus exposed Kirschner wires following fixation of metacarpal and phalangeal fractures: a national clinician and patient survey |
| title_fullStr | Buried versus exposed Kirschner wires following fixation of metacarpal and phalangeal fractures: a national clinician and patient survey |
| title_full_unstemmed | Buried versus exposed Kirschner wires following fixation of metacarpal and phalangeal fractures: a national clinician and patient survey |
| title_short | Buried versus exposed Kirschner wires following fixation of metacarpal and phalangeal fractures: a national clinician and patient survey |
| title_sort | buried versus exposed kirschner wires following fixation of metacarpal and phalangeal fractures a national clinician and patient survey |
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