In this section
Kirschner wires (K-wires) are stiff, straight wires that are sometimes needed to repair a fracture (broken bone). K-wires are also commonly called ‘pins’.
If your child has a fracture that requires surgery, they may need K-wires to help hold the bones in place until they heal. They are most commonly used for supracondylar (elbow) or wrist injuries. Depending on the location and severity of the fracture, sometimes multiple K-wires are
K-wires are only needed temporarily – once the bones have healed, the K-wires are removed during an outpatient appointment.
A surgeon will need to put K-wires in during an operation – the surgeon will intentionally place the K-wires so the ends stick out of your child’s skin. This is so the wires can be removed three to four weeks after surgery, without the need for another operation.
The wires are covered with a padded dressing and the injured area is placed in a removable backslab (a partial cast held in place with bandages) or in a ready-made splint.
Your child will not be able to see or feel the wires under the padded dressing and it is important that you or your child do not to try to see or disturb the wires.
For more information about fractures and plaster cast care, see our fact sheet
Fractures (broken bones).
Even though complications are rare, you will need to monitor your child at home for possible problems after K-wire insertion. Irritation where the wires exit the skin is common, but infection is rare (about one in one hundred patients). If your child shows any of the following signs
of infection, you should contact your doctor or treating hospital:
Your child will have an appointment scheduled three to four weeks after surgery so that the K-wires can be removed.
If you think your child (or you as a parent/carer) will be particularly anxious or worried and need additional support during the procedure, please let your doctor know before your appointment. For patients of The Royal Children’s Hospital, a child life
therapist or Comfort Kids team member may be available to provide strategies to alleviate procedure-related anxiety. You can check what supports are available with your treating hospital or medical team. See our fact sheet
Your child’s hospital stay.
In rare cases light sedation is available but your child will have to fast from food and drink for a minimum of two hours ahead of time, however the majority of patients can have successful removal of K-wires without sedation. See our fact sheet
Sedation for procedures.
On the day of the appointment:
Throughout the procedure, your doctor or a nurse will use distraction techniques to help reduce stress for your child. Clear explanations and reassurance will be given by the team and you are encouraged to help comfort and reassure your child.
Once the wires are pulled, there will be tiny wounds (called pin sites) which may bleed, so a gauze dressing will be applied with some pressure for 30–60 seconds. Once the bleeding stops, the wounds will be covered with a clear dressing.
Your child’s skin may be dry and itchy after the cast has been removed. Once the pin sites have healed, bathe the skin with warm soapy water, and apply a plain, non-perfumed moisturiser.
After a fracture, children normally regain strength by gradually participating in gentle activity and play. Physiotherapy is usually not needed.
Will my child set off metal detectors if she has wires in?
Metal detectors will not usually detect these wires. There are thousands of people who have large amounts of metal in their bodies permanently who go through airports daily, often without setting off metal detectors.
How thick are the K-wires, and how much sticks out of the skin?
The wires typically have a diameter between 1.6 mm and 2.0 mm in diameter and about 2 cm sticks out from the skin.
I’m worried that my child will be awake while the wires are removed. How painful is the procedure?
The removal of K-wires is usually very quick – each wire removal only takes one to two seconds. Your child may feel tugging, along with some very brief discomfort.
Young patients who have had the procedure usually say ‘it wasn’t too painful’ or ‘it’s OK, it’s just a little sore’. Parents often report that their child is a little upset straight after the procedure, but they recover quickly and are fine within a few minutes.
Developed by The Royal Children's Hospital Orthopaedic department. We acknowledge the input of RCH consumers and carers.
Developed October 2019.
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