title: Successful treatment of Buerger's Disease with intramedullary K-wire: the results of the first 11 extremities.
abstract: OBJECTIVE
  This study describes a new technique for treatment of Buerger's disease, developed to stimulate angiogenesis, using a Kirschner wire placed in the medullary canal of the tibia. The aim of the study was to evaluate clinical and radiological effects of this technique in patients where medical and surgical therapy had failed.
  
  
  METHODS
  Eleven extremities (six patients) with Buerger's disease were treated with the intramedullary Kirschner wire technique. Inclusion criteria were chronic critical ischemia, Rutherford Grade II or III, with major arterial occlusion shown by Doppler examination and angiography; failure to respond to non-surgical and surgical treatment; and the need for strong analgesics.
  
  
  RESULTS
  The mean follow-up time was 19 months (range, 13-25 months). Satisfactory remission in each patient was obtained within 6 weeks of intervention. A significant improvement in clinical manifestations including reduced rest pain and increased claudication distance was observed. Foot ulcers completely healed after Kirschner wire intervention.
  
  
  CONCLUSIONS
  Despite short-term follow-up and small patient series, the intramedullary Kirschner wire technique can be expected to achieve relief of pain and a decrease in major amputations in patients with Buerger's disease in whom medical and surgical therapy had failed. However, comparative studies with longer follow-up should be done to confirm the benefits of this new treatment.
authors.affiliation: Department of Orthopedics and Traumatology, Medical Faculty, Turgut Ozal Medical Center, Inönü University, Malatya, Turkey. minan@inonu.edu.tr
authors.forename: M
authors.initials: M
authors.lastname: Inan
authors.forename: I
authors.initials: I
authors.lastname: Alat
authors.forename: R
authors.initials: R
authors.lastname: Kutlu
authors.forename: A
authors.initials: A
authors.lastname: Harma
authors.forename: B
authors.initials: B
authors.lastname: Germen
mesh_terms: D000328:Adult; D001864:Bone Wires; D003097:Collateral Circulation; D005260:Female; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D018919:Neovascularization, Physiologic; D019637:Orthopedic Procedures / Q000295:instrumentation*; D012074:Remission Induction; D012189:Retrospective Studies; D013919:Thromboangiitis Obliterans / Q000503:physiopathology / Q000601:surgery*; D013977:Tibia / Q000601:surgery*; D016896:Treatment Outcome