Soft Tissue Complications Following Kirschner Wire Fixation for Fusion of Basal Joint Arthritis.
Basal joint arthritis is a common hand condition presenting with pain and swelling, often requiring surgical treatment in the late stages. Surgical options include arthrodesis, excision arthroplasty, implant arthroplasty and ligament reconstruction, and tendon interposition arthroplasty. A patient with bilateral basal joint arthritis underwent K-wire arthrodesis of the left basal joint. Subsequently, she developed complications due to impingement of the K-wire on the median nerve, superficial radial nerve, and flexor tendons of the index finger. The diagnosis was made three years post-operatively and she then underwent reconstructive surgery. Eventually she recovered with good movement and sensation of the affected digits. Although K-wire arthrodesis of basal joint is a simple and effective procedure used primarily in treatment of arthritis, this case highlights the importance of appreciating surgical anatomy and post-operative clinical features and investigations.
Koh
WI
Department of Hand Surgery, Singapore General Hospital, Singapore.
Lim
BH