Postoperative Management of Kirschner-Wire Fixation of All Phalangeal and Metacarpal Fractures at a Single Tertiary Care Center: A Retrospective Review
Bibliographic record
Abstract
Introduction: Kirschner-wire (K-wire) fixation (KF) is the most common operative technique for hand fractures among Canadian plastic surgeons. However, postoperative rehabilitation varies widely and rely on low-quality studies and expert opinion. The study reviewed KFs of phalangeal and metacarpal fractures at a single academic center to quantify practice variation and patient outcomes. Methods: This retrospective chart review analyzed all cases of KF of isolated phalangeal and metacarpal fractures performed by all plastic surgeons at a single tertiary care center in the last 7 years. The primary outcome was the duration from operation to K-wire removal. Secondary outcomes included the time from KF to range of motion (ROM) initiation, the interval between K-wire removal and ROM initiation, postoperative complications, and functional outcomes. Results: Among 289 patients, mean time from KF to K-wire removal was 28.6 days (SD 8.2). There was a high variability among the surgeons, with the shortest duration averaging 26 ± 6 days and the longest averaging 33.7 ± 8.6 days ( P < .001). Mean time to initiation of ROM was similar across surgeons (mean 25.2 ± 11.4 days). Postoperative complications occurred in 26 patients (10.9%), primarily pin site infections (6.7%). Early versus late K-wire removal did not affect complication rates. There were no differences in functional outcomes between surgeons. Conclusion: There is considerable variability in postoperative rehabilitation following KF of hand fractures among surgeons at a single academic center. Our study suggests that supervised ROM can be initiated safely as early as 3 weeks postoperatively, regardless of whether K-wires remain in situ.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".