Complications

Radial sensory neuritis is occasionally noted postoperatively. This potential complication can be minimized by identification and retraction of the radial sensory nerve branches out of the operative field during the procedure. In the authors' experience, the rare patient that develops radial sensory neuritis can expect full recovery within a year.

K-wire problems include skin irritation around the pin, loosening, and migration. The risk of pin-skin irritation is minimized by releasing undue skin tension around the pin at the time of surgery. Pin track infections are possible, but are rarely encountered. Pin loosening and migration can be prevented with precise placement of the pin within the center axis of each metacarpal; with the wire driver turning at low speed; with as few passes of the pin as possible, just barely penetrating the second cortex of the anchoring bone with only the tip of the K-wire; and with protecting the trailing end of the K-wire against pressure from the overlying splint or cast [9,10]. A loose or migrated pin usually requires early removal. In our reported series [8], early K-wire removal did not cause noted deterioration of results. These patients were still immobilized for the full 5.5 weeks in a short arm-thumb spica cast.

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