Percutaneous K-wire fixation is often used for transverse fractures of the middle phalangeal diaphysis.
The advantages are:
- Minimal soft-tissue insult
- Low cost
- Universal availability
However, there are some disadvantages which can sometimes be significant, such as:
- Less stable fixation
- No interfragmentary compression
- May separate the fragments
- Delayed mobilization
- May irritate the overlying skin
f the fracture is visible on AP view a lateral approach is used.
If the fracture is visible on lateral view a dorsal approach is used.
The wire should be inserted in the coronal plane, in order to avoid impaling any tendons.
Be sure that the point of entry in the side of the finger is dorsal to the neurovascular bundle.
Use a fine drill guide through a small stab incision.
Insert the wire into the near fragment, then confirm reduction before advancing into the far fragment.
Make sure that the tip of the wire engages the opposite cortex but does not project beyond it.