RecruitingInterventional

Buried versus exposed wires in hand and wrist fractures

If you break a bone in your hand or wrist and need surgery, doctors often use thin wires called K-wires to hold the bone in place while it heals. This study wants to find out if it's better to leave the ends of these wires sticking out of your skin or to bury them completely underneath. The main goal is to see which method causes fewer infections around the wires. We also want to understand if one way of doing it affects your recovery and how much it costs the NHS. By joining, you'll help doctors make better decisions about care for future patients with similar injuries. The study is run by the University of Oxford and funded by the National Institute for Health and Care Research.

At a glance

Status

Recruiting

Sponsor

University of Oxford

Enrolment target

470

Start

26 Jan 2026

Estimated completion

28 Feb 2027

Musculoskeletal

What is this study about?

When someone breaks a bone in their hand or wrist, surgery is sometimes needed to fix it. This often involves using thin metal wires, called K-wires, to hold the bones steady while they heal. There are two main ways doctors can place these wires: they can either leave a small part of the wire sticking out of the skin, or they can cut the wire short so it's completely hidden beneath the skin. Doctors aren't sure which method is best, and they want to find out if one way is safer or helps people recover better.

The main concern is the risk of infection. If part of the wire is sticking out, there's a chance germs could get in where the wire meets the skin, causing what's called a 'pin site infection.' These are usually treated with antibiotics, but serious infections can cause more pain, delay healing, or even lead to more surgery. On the other hand, if the wires are buried, they might need a small second operation to remove them later, which means another trip to the hospital.

This study aims to compare these two methods. By carefully looking at how many infections happen with each method, how people recover, and what the costs are, the researchers hope to provide clear information that will help doctors across the UK decide the best way to treat hand and wrist fractures. Your participation can make a real difference in improving care for patients in the future.

Key takeaways

Compares two ways of using wires to fix broken hand/wrist bones.
Aims to find out which method causes fewer infections and is more effective.
You'll be randomly assigned to either 'exposed' or 'buried' K-wires.
Participation involves answering questions at the start, 3 months, and 6 months.
No direct personal benefit, but helps improve future patient care.
Risks are similar to standard care, but vary slightly between methods.

Who may be eligible?

You might be able to take part in this study if you are 16 years old or older and have a broken bone in your hand or wrist that your doctor says needs to be fixed with K-wires. This applies whether the skin over your injury is open or closed.

There are a few reasons why you might not be able to join. For example, if there isn't enough skin over your broken bone to completely cover a buried wire, or if you have a skin infection or problem near the injury. Also, if your injury happened more than two weeks ago, or if you wouldn't be able to come to all the follow-up appointments and complete the study tasks, you wouldn't be eligible.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Are you 16 years old or older?
Do you have a hand or wrist fracture that needs K-wires for surgery?
Is your injury less than 2 weeks old?
Do you have enough healthy skin over the injury to potentially bury a wire?
Are you able to attend follow-up appointments for the study?

Answer every question to see your result.

What does participation involve?

If you decide to take part, a research team member will talk to you, explain everything, and answer all your questions. If you agree, you'll sign a consent form. You'll then be asked some questions about yourself, your health, and your quality of life, including how well you could do daily activities before your injury. This first set of questions will take about 15 minutes. You'll be asked similar questions again at 3 and 6 months after your injury.

To compare the treatments, you'll be randomly placed into one of two groups. In the 'exposed K-wires' group, the ends of the wires will stick out about an inch from your skin. They will be covered with a sterile dressing and usually a cast. The wires will be removed during a standard hospital visit after about 6 weeks. In the 'buried K-wires' group, the wires will be completely under your skin. You'll also get stitches and a cast. After about 6 weeks, you'll return to the hospital, usually to an operating room, where a local anaesthetic will be given, and a small cut will be made to remove the wires.

Potential risks and benefits

There isn't a direct personal benefit for you by joining this study, as we don't know yet if one treatment is better than the other in how you recover. However, the information gathered from your participation will be very important for improving care for future patients with similar injuries and helping the NHS understand the best use of its resources. The risks of taking part are similar to the risks of standard care because both types of K-wire treatment are already used. However, there are some differences: exposed wires might have a slightly higher risk of infection, while buried wires mean you'll need a second procedure under local anaesthetic to remove them. You are free to withdraw from the study at any time without affecting your medical care.

Locations (28)

Royal United Hospital
Approximate
Bath, England
Queen Elizabeth Hospital
Approximate
Birmingham, England
Stoke Mandeville Hospital
Approximate
Aylesbury, England
St Thomas' Hospital
Approximate
London, England
Basingstoke and North Hampshire Hospital
Approximate
Basingstoke, England
St Mary's Hospital
Unverified
London, England
St James' S University Hospital
Unverified
Leeds, England
Musgrove Park Hospital
Unverified
Taunton, England
Queens Medical Centre
Unverified
Nottingham, England
John Radcliffe Hospital
Unverified
Oxford, England
Royal Cornwall Hospital
Unverified
Truro, England
Salford Royal Hospital
Unverified
Salford, Greater Manchester, England

Common questions

What are K-wires?

K-wires are thin metal wires that doctors use to hold broken bones in your hand or wrist in place while they heal.

Why is this study being done?

This study is being done to find out whether it's better to leave K-wire ends exposed outside the skin or buried underneath, aiming to reduce infections and improve recovery for people with hand and wrist fractures.

Will I get to choose which K-wire treatment I receive?

No, you will be randomly placed into one of the two treatment groups (exposed or buried K-wires) to ensure a fair comparison.

How long will I be involved in the study?

You'll be involved in answering questions at the start and then at 3 and 6 months after your injury.

Who is running this study?

The University of Oxford is sponsoring this study, with day-to-day management by their Oxford Trauma and Emergency Care team.

How to find out more

Justin Wormald

HAWAII-DRIFT@ndorms.ox.ac.uk +44 01865 612709 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.