title: A novel technique to prevent guide wire related complications while inserting the 4.0 mm cannulated screws.
abstract: BACKGROUND
  Cannulated screws (4.0 mm) provide inter-fragmentary compression and stability to fractures. A guide wire is used to define the screw trajectory and hold the fracture fragment while the screw is being inserted. The cannulated shaft typically accommodates a 1.25 mm guide pin. Since the guide pin is very slender and undergoes elastic deformation during insertion, there is a high probability of pin breakage.
  
  
  METHODS
  The authors have devised a new way to place the 4.0 mm cannulated screws in a manner that prevents the intraoperative complication of guide wire breakage. For this technique, predrilling was achieved using a 2.0 mm K-wire which was subsequently replaced with a 1.25 mm guide pin under the protection of sleeve. 4.0 mm cannulated screws were then inserted into a defined trajectory over the guide pin.
  
  
  RESULTS
  Using the technique, over 20 patients were managed in our department over a period of two years without any complications.
  
  
  CONCLUSIONS
  We have observed that patients treated with this method experience short operation time, combined with good clinical outcome and we recommend its use in cases where cannulated screw use is warranted.
authors.affiliation: The Division of Orthopedic Traumatology, The First Hospital of Jilin University, Changchun, Jilin, China.
authors.forename: Bao-Chang
authors.initials: BC
authors.lastname: Qi
authors.affiliation: The Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin, China.
authors.forename: Wei-Na
authors.initials: WN
authors.lastname: Ju
authors.affiliation: The Division of Orthopedic Traumatology, The First Hospital of Jilin University, Changchun, Jilin, China.
authors.forename: Tie-Jun
authors.initials: TJ
authors.lastname: Wang
authors.affiliation: The Division of Orthopedic Traumatology, The First Hospital of Jilin University, Changchun, Jilin, China.
authors.forename: Tie-Cheng
authors.initials: TC
authors.lastname: Yu
authors.affiliation: The Division of Orthopedic Traumatology, The First Hospital of Jilin University, Changchun, Jilin, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: The Division of Orthopedic Traumatology, The First Hospital of Jilin University, Changchun, Jilin, China.
authors.forename: Da-Hui
authors.initials: DH
authors.lastname: Sun
mesh_terms: D001863:Bone Screws; D001864:Bone Wires; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D061646:Operative Time
keywords: Cannulated screws; defined trajectory; elastic deformation; fracture fragment; pin breakage; screw trajectory