Kirschner wire handle (clamp) the development and clinical application

2013-07-05 14:47:01

Wang Xinyi, Jiang Xiaoqi

(Qishuyan District People's Hospital, Changzhou, Jiangsu)

Orthopaedic Kirschner is one of the most commonly used devices, need to use hand drill or drill operation, when a medical emergency is difficult to operate. To this end we designed a handle (pliers), it is easy to install fixed Kirschner, patients who just left fixed fracture, right hand to hold the handle (pliers) for Kirschner operation. Patients who achieved a Kirschner wire that can do given the purpose of indole, simple operation, good effect.

1 Materials and methods

1.1 Materials

Kirschner wire handle (pliers) illustration: Kirschner hand by the fastening nut, pressure tank, external thread, needle tract, plugs and other structural components. Kirschner wire clamp from the needle tract, shaft, pressing blocks, pressure handle, fixed gear and other structural components (as shown).

1.2 instrumentation

The use of Kirschner handle: insert the Kirschner pin tail handle needle tract, Gushan nut clockwise tightly, Kirschner incurs fixed on the handlebar, the direct rotary handle needle. Turn the nut counterclockwise to loosen tight tight Gushan indole nut removed Kirschner.

Kirschner clamp used: insert the end of the Kirschner Kirschner wire pliers needle tract, the pressing pressure handle can be fixed Kirschner, release pressure handles to remove the Kirschner wire.

2 Clinical Applications

2.1 Clinical data

The patients are our department in March 1996 - May 2000 admitted 132 patients, 98 males and 34 females; aged 10-83 years, mean 36 years. Phalangeal fractures in 74 cases, toe fracture in 15 cases, 14 cases of metatarsal fractures, metacarpal fractures in 27 cases, one case of humeral condylar fracture, fracture of the anterior superior iliac crest l cases. Open fractures in 67 cases, 65 cases of blunt arms folded.

2.2 surgical methods

Finger (toe) bone fracture: anesthesia debridement proposed distal fracture, holding forceps antegrade Kirschner Kirschner penetrate the distal fracture, such as the proximal phalanx (phalanx) fractures Received date: 2004 - 07-16: Revised :2004 -09-18

About the author: Wang Xinyi (19 59 -), male, deputy director of the attending physician. Phone: 0519-8770577.

The buckling proximal (toe) between the joints, Kirschner wire from which the phalanx Cosco 1/3 of the dorsal piercing; such as the section refers to the (toe) bone fractures from finger (toe) end of the piercing, loosen exit g s needle clamp, and then the fracture is installed on a remote Kirschner Kirschner clamp, clamp holding Kirschner needle back to fracture, proximal reset Kirschner drill, cut far too long Klinefelter needle stitched the wound.

Metacarpal fractures: Take dorsal incision made distal fracture, flexion of the metacarpophalangeal joint, holding forceps antegrade Kirschner Kirschner penetrate the distal fractures and joints from the piercing, loosen exit Kirschner clamp, then the fracture is installed on a remote Kirschner Kirschner clamp, clamp holding Kirschner needle back to fracture after a reset from the dorsal proximal Kirschner drill piercing, Kirschner wire clamp and re-installed on the proximal distal Kirschner Kirschner will retreat into metacarpal bones, the proximal cut after bending, stump buried in the skin ¨], suture wounds.

Finger (toe) distal bone fractures: After reset, the left hand fixed fracture, right hand holding Kirschner wire clamp from retrograde penetration phalanx finger, cut long Kirschner wire fixation of the fracture.

Metatarsal fracture: dorsal incision revealed the fracture, Kirschner wire along the long axis parallel to the dorsal cortical fracture transport terminal to enter, after metatarsal head, below the base of proximal phalanx, and then the plantar side of the skin at the toe piercing the fractures, retrograde Kirschner then penetrate beneath the cortex along the dorsal metatarsal fractures of the proximal Yang], cut long Kirschner, stump buried in the skin.

Avulsion fracture: closed pry pull reset port 1, the left temporarily fixed, right hand holding the handle penetrating Kirschner Kirschner wire fixation, after bending Cut off the excess Kirschner, stump buried intradermal.

The group of 132 cases of anatomical reduction 115 cases, 17 cases of functional reduction (both fracture). After fixation without further displacement phenomenon, no pinholes infections and osteomyelitis. 4 Discussion

Handlebar clamp with Kirschner Kirschner choice: mainly based on the surgeon's operating habits can take any one kind. Our experience is generally thick Kirschner wire by hand, often used as a pry pull reset, direct hit into the Kirschner; small Kirschner Kirschner wire clamp, often in emergency door phalanges, phalanx, metacarpal fractures, etc. Using fixed.

Operation, the Kirschner wire handle (pliers) and forearm parallel to the long axis, thenar against the handle (clamp) the end of the thumb and index finger basically straight, middle finger, ring finger, little finger flexion, grip the handle (pliers), so that when the needle remained Kirschner parallel, to avoid excessive swing. General Diao i use a hammer blow into Kirschner, such as individual cases to be used, the Kirschner wire should reach the end of the needle tract, and then spin the nut or clamping lever firmly Gushan, to avoid pinning the handle (clamp) within the loose .

The method is simple instruments, disinfection convenient, especially for primary hospital only one doctor on duty even when the fixation for fracture reduction surgery, and then use a hand drill into inoperable. Wide range of applications, easy to operate, can Kirschner wire fixation of fractures of the basic can use the handle (pliers) needle operation. Since the handshake (clamp) needle must be screwed directly drill, hand drill without the gear structure, torque, through the bone cortex difficult, so the cortical bone fixation apply.

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