The authors performed a prospective, randomized trial comparing the infection rates of Kirschner wires left percutaneously to those buried deep to the skin surface. Fifty-six patients with distal radius fractures were included in their study. The fractures in 29 cases were stabilized with percutaneous wires (total 50 wires), whereas the fractures in 27 cases were treated with buried wires (49 wires). Patients were assessed at 2 and 6 weeks postoperatively. Using a modification of the Oppenheim Classification for infection, the authors found a significantly greater infection rate in patients treated with percutaneous wires left outside the skin (p = 0.02).
The incidence of infection increases with the length of time in which Kirschner wires are left in situ (Botte, Clin Orthop, 1992). The authors of this study have recommended burying wires which will be maintained in bone for longer than 8 weeks and wires crucial to fixation. When pins communicate with the joint, a pin tract infection may lead to pyarthrosis. This should be taken into consideration.
J Hand Surg 29B:374-376, 2004.