Kirschner Wire Tip Configurations
- Diamond – Single or Double-ended
- Trocar – Single or Double-ended
Trocar Tips for Drilling K-Wires
Previous research had revealed that trocar tips have the greatest holding power, yet also generate the highest temperatures during drilling. When drilling, the debris produced at the tip is not cleared from the point. As the debris compresses, it results in increased friction, which leads to significantly higher temperatures inside the bone. If thermal heat is too high or sustained for too long, complications arise – including acute vascular insufficiency and reduction of osteocytes.
Hammering K-Wires is Superior to Drilling with Irrigation, by Bas B. G. M. Franssen, Arnold H. Schuurman, Pascal C. R. Brouha and Moshe Kon.
Irrigation During Drilling
- Use Ringer lactate solution to cool the drill bit and minimize thermal injury
- Fluoroscopy is recommended during drilling
Hammering versus drilling of sharp and obtuse trocar-point k-wires, (Abstract) by B. B. Franssen, A. H. Schuurman, A. B. Mink Van der Molen and M. Kon.
Drilling of Kirschner wires exert high heat due to drilling at high speed and because the wire has a permanent snug contact to the bone. To minimize the high heat produced by power drills, “leading hand surgeons recommend drilling K-wires by hand whenever possible.”