title: Complications when using threaded K-wire fixation for displaced intra-articular calcaneal fractures.
abstract: A retrospective chart review was performed on patients treated at a level one trauma centre for displaced intra-articular calcaneal fractures by a single trauma surgeon between January 1998 and July 2007. Patients were treated with open reduction and internal fixation utilising the extended lateral incision and a new type of fixation not described before. Threaded 1.575 mm (0.062 in.) Kirschner wires (K-wires) were used for fixation post-operatively along with standard plates, screws and bone substitute. There were 278 fractures in 246 patients that were treated with ORIF for displaced intra-articular calcaneal fractures during this 9-year period. Standard calcaneal lateral approach and hardware was supplemented with percutaneous threaded K-wires. An average of 5.0 fully threaded 1.575 mm K-wires were inserted per calcaneal fracture. Five (1.8%) patients had a K-wire infection; 0.6% of all K-wires became infected and 3.1% of K-wires broke. Lateral calcaneal apical wound issues are minimised and patients experience an overall low complication rate. The fixation also ensures non-weightbearing compliance.
authors.affiliation: Department of Surgery, University of Calgary, Calgary, Alberta, Canada.
authors.forename: A Ross
authors.initials: AR
authors.lastname: Demcoe
authors.forename: Marieke
authors.initials: M
authors.lastname: Verhulsdonk
authors.forename: Richard E
authors.initials: RE
authors.lastname: Buckley
mesh_terms: D000328:Adult; D001860:Bone Plates; D001863:Bone Screws; D001864:Bone Wires / Q000009:adverse effects*; D002111:Calcaneus / Q000293:injuries*; D020878:Device Removal / Q000379:methods; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D050723:Fractures, Bone / Q000145:classification / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D008297:Male; D010349:Patient Compliance; D019919:Prosthesis Implantation / Q000379:methods; D016459:Prosthesis-Related Infections / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D016474:Weight-Bearing