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 Table of Contents  
LETTER TO EDITOR
Year : 2022  |  Volume : 3  |  Issue : 2  |  Page : 42-43

A handy kitchen tool for simple wire or pin removal at rural clinics


Department of Orthopaedics, Government Medical College, Haldwani, Uttarakhand, India

Date of Submission08-Mar-2022
Date of Decision25-Mar-2022
Date of Acceptance04-Apr-2022
Date of Web Publication07-Jul-2022

Correspondence Address:
Ganesh Singh Dharmshaktu
Department of Orthopaedics, Government Medical College, Haldwani - 263 139, Uttarakhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jssrp.jssrp_3_22

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How to cite this article:
Dharmshaktu GS. A handy kitchen tool for simple wire or pin removal at rural clinics. J Surg Spec Rural Pract 2022;3:42-3

How to cite this URL:
Dharmshaktu GS. A handy kitchen tool for simple wire or pin removal at rural clinics. J Surg Spec Rural Pract [serial online] 2022 [cited 2022 Dec 3];3:42-3. Available from: http://www.jssrp.org/text.asp?2022/3/2/42/350164



Dear Editor,

Many bone fractures are managed by one or multiple Kirschner wire (K-wire) fixation. K-wire is a widely used implant in orthopedic and trauma surgery.[1] This is a simple smooth stainless steel or titanium wire with pointed ends to penetrate the bone from either side. After the fixation, the wire is cut to size in most cases to remain outside the body so that to be removed easily in the follow-up. Most of percutaneous fixation done with these wires result in one end outside the skin or just buried under the skin. The wire is removed with longitudinal pull outward with the help of bone pliers and is an easy outpatient procedure that is safe and usually does not require anesthesia.[2] Many a times, people from far-flung areas are not able to attend the clinic in due time and risk of complication of retained wire like infection, migration, or their breakage is increased.[3] The removal is advised to be done under medical supervision and preferably at the center of surgery. In extreme situations and in rural primary care settings, the procedure can be done with simple training or remote supervision in the absence of specialist doctors, which is a common problem in developing countries.

A handy tip is shared by us that can help in such extreme situations or in tough times. A well-known and widely available kitchen appliance called “pakkad” in local language, in many parts of India [Figure 1]a, is a sort of domestic plier used to hold and handle hot utensils on or off the stove while cooking. This is a strong and sturdy metallic appliance with a long nose lined with coarse serrations that make it capable of good grip around the object. A long handle gives good lever arms to exert sufficient force and may hold wires or pins through the length and pull it straight in longitudinal axis [Figure 1]b. This proposal should be used cautiously in selected cases where the benefits outweigh the cost or efforts to commute to a nearby specialist center. The.described method can be used only in the cases where one end of wire/pin is visible and that too after ensuring that removal is indicated. We have personally used this appliance in few cases in our clinic and found no problems with the technique. This technique, however, cannot substitute expert opinion. In rural settings or hilly areas, which are remote or where specialist opinion is not readily accessible this proposed technique may be used in selected cases. Distance between good health-care centers is an important contributor to health-care delivery in rural areas.[4] A virtual online observation with specialists may add to the success of the procedure. Telemedicine has been found an important option in rural health-care delivery.[5] In the COVID-19 pandemic period, many cases were left unattended or missed their follow-up schedule due to various reasons. In future lockdowns or pandemic situations, the proposal may provide some benefit to selected cases in rural areas.
Figure 1: The image of “pakkad” the domestic plier with a nose and long handle and the long nose that can well accommodate wires (a) and wires can be pulled easily following straight longitudinal pull as demonstrated here on a vegetable model (b)

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Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

Ganesh Singh Dharmshaktu



 
  References Top

1.
Franssen BB, Schuurman AH, Van der Molen AM, Kon M. One century of Kirschner wires and Kirschner wire insertion techniques: A historical review. Acta Orthop Belg 2010;76:1-6.  Back to cited text no. 1
    
2.
Sorenson SM, Hennrikus W. Pain during office removal of K-wires from the elbow in children. J Pediatr Orthop 2015;35:341-4.  Back to cited text no. 2
    
3.
Sharma H, Taylor GR, Clarke NM. A review of K-wire related complications in the emergency management of paediatric upper extremity trauma. Ann R Coll Surg Engl 2007;89:252-8.  Back to cited text no. 3
    
4.
Fyfe TM, Payne GW. Rural healthcare delivery: Navigating a complex ecosystem. Healthc Manage Forum 2020;33:80-4.  Back to cited text no. 4
    
5.
Woodall T, Ramage M, LaBruyere JT, McLean W, Tak CR. Telemedicine Services during COVID-19: Considerations for medically underserved populations. J Rural Health 2021;37:231-4.  Back to cited text no. 5
    


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