Kirschner wire pin tract infection rates between percutaneous and buried wires in treating metacarpal and phalangeal fractures.

OBJECTIVE: To compare pin tract infection rate between percutaneous and buried placement of Kirschner (K-) wiring for hand fractures. STUDY DESIGN: Quasi--experimental study. PLACE AND DURATION: Plastic, Reconstructive, Hand and Burn Surgery Unit, Liaquat National Hospital, Karachi, from September 2005--February 2006. PATIENTS AND METHODS: Patients with fractures of metacarpals and phalanges of hand were selected by non-probability purposive method. Assessment of pin tract infection by clinical examination and pin tract scoring was done by modification of Oppenheim classification. Statistical analysis was done using Chi-square test. RESULTS: Ten out of 55 percutaneous and 2 out of 45 buried wires were infected. The difference in infection rates of two groups was statistically significant at p<0.05. Three percutaneous, but not buried Kirschner wires, had to be removed before 4 weeks because of failure to respond to local wound care and oral antibiotics. CONCLUSION: Percutaneous K- wires had significantly greater infection rate than wires which were buried deep to the skin.