From the Research
Removing a K-wire can cause discomfort, but the level of pain varies depending on several factors, and most removals cause mild to moderate pain that is typically brief and manageable. The pain experienced during K-wire removal can be influenced by factors such as the location and depth of the wire, the age and sex of the patient, and the presence of any complications like infection or wire breakage 1. According to a recent study published in 2023, the mean age of patients treated was 7.1 years, and there was a statistically significant increase in pain parameters in girls, right extremity fractures, and the group over 8 years old 1.
Factors Influencing Pain
- The location and depth of the K-wire: deeply embedded K-wires may require local anesthesia to minimize pain
- The age and sex of the patient: girls and older children may experience more pain during removal 1
- The presence of complications: infection or wire breakage can increase the risk of pain and other complications 2
- The presence of parents during the procedure: having both parents present can increase pain parameters in children 1
Managing Pain
- Local anesthesia can be administered before removal to minimize pain
- Over-the-counter pain medications like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can be used to manage soreness after removal at standard dosages (acetaminophen 325-650mg every 4-6 hours or ibuprofen 400-600mg every 6-8 hours as needed)
- Patients should follow post-removal care instructions, including keeping the site clean and watching for signs of infection such as increasing pain, redness, swelling, or discharge
Recent Findings
A 2023 study found that physicians should consider the conditions that may increase pain during K-wire removal, such as the patient's sex, age, and the presence of parents, to ensure a less painful and positive experience 1. Another study published in 2022 highlighted the importance of providing parents with more procedural information beforehand, especially regarding pain and sedation, to improve their experience and reduce anxiety 3.