The Kirschner wire guide

Ord and Sw~~rv ( I994 I32.4849 ti 1994 The British Asruclauon of Oral and Maxillofacial Surgeons 1 , .

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I

The Kirschner wire guide P. M. Adamson, P. S. Douglas Depurtment of Oral und Maxillojhzl

Surgery, Canniesburn Hospitul, Beursden, Glasgow

SUMMARY. The Kirschner wire guide is a useful means of introducing K-wires into the facial skeleton. It can be easily constructed in the maxillofacial laboratory and its use allows accurate positioning of K-wires, especially in fractures of the zygomatic complex.

THE KIRSCHNER

WIRE GUIDE

The Kirschner wire (K-wire) is a useful method of stabilising facial fractures. The transnasal K-wire is particularly valuable as a method of fixation of unstable fractures of the zygomatic complex.’ It has been shown that this method is a quick and efficient means of support with a low morbidity.’ In the same study it was noted that malar fractures involving fronto-zygomatic displacement often required several attempts at K-wire insertion to achieve stability, despite the insertion of an interosseous wire at the suture. In view of this the K-wire guide was devised (Fig. 1). This consists of two metal tubes (A & B) which lie in the same plane, connected together by a reinforced metal bar (C). Tube A has a portion of K-wire inserted which can be moved within the tube although its removal is prevented by a ball of solder at each end. The transnasal K-wire is inserted through tube B, in the direction of the arrow, using the wire in tube A as a guide. The tubes are constructed from stainless steel of a diameter just sufficient to allow passage of a 1.5 mm diameter K-wire. The guide is placed on the face following elevation of the fracture (Fig. 2). Tube B is placed against the nose, with the wire in tube A being pushed against the facial skin just below the body of the zygoma. The length of the K-wire in the driver can then be

Fig. 2 - The guide

held against

the face

adjusted according to the guide and its path of insertion will automatically follow the direction of the tubes. This device has been helpful particularly in learning the technique of transnasal K-wire insertion. Its adjustability also allows its use in the fixation of other fractures of the facial skeleton.

Acknowledgements The authors would like to thank Technician, Canniesbum, for the Medical Illustration Department, K. F. Moos and Mr A. E. El their patients.

Mr George construction Cannicsbum Attar for

Payne, Maxillofacial of the guide: The Hospital: Professor allowing its USC on

References

Fig. 1 -The

K-wire

I. Brown J, Barnard D. The transnasal Kirschner wire as a method of fixation of the unstable fracture of the zygomatic complex. Br J Oral Surg 1983; 21: 208-213. 2. Stassen LFA, Moos KF, El-Attar AE. A comparison of the use of external pin and transnasal Kirschner wire hxation for the unstable tripod malar fracture: A prospective trial. Br J Oral Maxillofac Surg 1989; 27: 99-106.

guide (see text for details). 48

The Kirschner

The Authors P. M. Adamson MB, Bch, BAO, FDS, Staff Grade Department of Oral and Maxiilofacial The City General Hospital Carlisle CA I 2HG P. S. Douglas FDS, RCS, FRCS Senior Registrar

RCPS

Department of Oral and Maxillofacial Canniesburn Hospital Bearsden Glasgow G6l I QL

wire

guide

Surgery

Surgery Correspondence

and requests

Paper received 29 March Accepted 21 May 1993

I993

for offprints

to Mr P. M. Adamson

49