2
Fracture of the wrist
K-wires /
Plate
Osteosynthesis with Kirschner wiring
Sometimes a cast for a broken wrist is not sufficient. Then an operation is necessary. In this case a minimal invasive technique is choosen. Through an incision of about 0,5cm two metal wires (K-wires) are drilled into the bone to ensure a good position. A cast is still needed, but the danger of renewed dislocation is far less.
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2
The fracture of the wrist / forearm is evident. A cast will not be enough. Osteosynthesis is indicated. With a drill the metal pins are introduced (3-5). An röntgen image intensifier is used (6-8).
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10
The result is a good position of the wrist / lower arm. After about 4-6 weeks the pins can be removed in the outdoor clinic without the need of anesthesia because the pins will loosen in the end.
In this patiënt it is better to use a plate, because the broken part will tend to dislocate. With a plate this can be avoided.
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2
In the picture the shortening of the wrist can be seen and also (in 2) that the lower part of the fracture is responsible for this. That is why the incision is made at theventral side of the wrist. Through the musculature the bone is reached and the fracture parts are freed. Reposition is achieved and a plate is applied to maintain the reposition. Fixation is done by screws (3-7).
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12
Then the muscle layer and the skin (subcutaneously) are closed (8-10). The x-rays show a good position of the fracture parts with normal length of the wrist.