martedì 9 aprile 2013

The Kirschner methodology: utilisation in Orthopedic First Aid

The Kirschner's methodology: application and advantages for the Orthopedic First Aid

Kirschner's methodology is an orthopedic technique used in surgery when is necessary to treat a fracture. It has been introduced by the surgeon Martin Kirschner, in 1909.

A Kirschner wire (also called a K-wire) is a thin, rigid wire that can be used to stabilize bone fragments. The wires are available from 0,8 mm to 4 mm, depending on the bone's size.
These wires can be drilled through the bone to hold the fragments in place.
They are placed percutaneously (through the skin), thus avoiding an operation in some cases.
In other cases, the K-wires are used after an operation to hold bone fragments in place.

The value is due to Mr. Kirschner, who has developped this precise technique for that aim, idealising both the metallic whire with differents dimeters, and the necessary equipment for the introduction in the bone.

The equipment consist in a drill for the introduction of the wire, the wire's guide, a traction's clamp, a traction's cord, some weights and a system of rods and pulleys in order to assure the hanging of the limb.


The K. method has the aim, tractioning the bone along its major axis, to win the tipical displacements of fractures and facilitate the reduction of them in favour of their healings.

In practice, the procedure consist in a previous retention of the reduction of the fracture (picture 1):

Picture 1


The bone's fragment has to be positioned in its original place, along the fracture's line.

Then, we have to insert n° 2 Kirschner's wires (picture 3) inside the bone, in the orthogonal direction with rescpect to the fracture's line (picture 2):

Picture 2

Picture 3

Between the advantages of this technique:
1)  a mini-invasive surgery;
2) the absence of cutaneous incisions;
3) the main solution to avoid fracture's breakdown;
And between the disadvantages there are:
1) the compulsory retention of the plaster cast or of the orthopedic support up to the complete strenghthening of the bone;
2) the risk of a potential breakdown of the fracture;
In conslusion, the highlight of this orthopedic procedure is to be particulary useful in Orthopedic  First Aid, where is not required to operate through an intervention but it's compulsory to act promptly.
The peculiarity of the technique, as mentioned, foresee the use of plaster cast, a valid support together with Kirschner's wires in favour of fractures's care.

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