Various operative techniques have been described for arthrodesis of the small joints of the hand and all produce similar satisfactory results (Leibovic, 1997). Well accepted techniques are Kirschner wire (K-wire) fixation (Wulle, 1999, K-wire with either intra-osseous or tension-band wiring (Lister, 1978), lag screws, plate or an external fixator. Each technique has its own advantages and disadvantages. The advantages of K-wire fixation include minimal stripping of soft tissue and periosteum, thus preserving blood supply. The disadvantages include bone heating during the passage of K-wires (Khanna et al., 1999) contributed to by accumulation of bone dust within the track created by the wire, leading to higher friction during insertion. Heating can lead to bone burns and predispose to implant loosening or infection. Crossing of the K-wires at the point of osteosynthesis should be avoided, as it can lead to distraction of the bone fragments and decreased rotational stability.
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