K-wires are thin steel pins used to hold broken finger, hand and wrist bones in place while they heal.
They’re often left poking out through the skin and removed in clinic, usually around three to six weeks after surgery.
Removal is typically quick, often done without an anesthetic, and more of a pull and pressure than a sharp pain.
Until then, PIN SITE CARE matters. Keep the pins clean, dry and protected, and watch for the signs of a pin site infection:
- spreading redness,
- pus,
- increasing pain, or
- a pin that starts to loosen
What K-wires are used for
- Finger fractures that won’t stay in line in a splint
- Metacarpal fractures, including some boxer’s fractures
- Thumb base fractures such as Bennett’s fracture
- Mallet fractures with a large fragment or a joint that has slipped
- Some wrist fractures, and to hold joints still after fusion or tendon repair
Pin site care
- Follow your surgeon’s instructions. Clinics differ: some want pins left alone under a dressing, others want gentle daily cleaning
- Keep them dry. A bag over the hand in the shower, and no swimming or soaking
- Keep them covered by the dressing, splint or cast so they can’t catch on clothing or bedding
- A little dried crust around the pin is normal. Don’t pick it
- Never bend, twist or pull a pin, and don’t let anyone else touch them
- Move the joints that are free, such as the fingers not involved, the wrist and the elbow. See swelling after a hand injury
A pin is a direct path from the outside world to your bone. Dry, covered and left alone is how you keep that path clean.
Pin site infection
Pin site infections are fairly common. Most are superficial and settle with oral antibiotics, but they need treating early.
- Redness spreading around the pin, not just a small pink ring
- Cloudy, yellow or green discharge, or a bad smell
- Pain that increases instead of settling
- Swelling around the pin, or the pin feeling loose or moving
- Fever or feeling unwell
Call your surgeon the same day if you notice these. See wound healing or infection.
Removal day
- Timing: usually three to six weeks, once the X-ray shows early healing. Finger fractures are often around four weeks
- The procedure: the clinician grips the pin with pliers and draws it out. It takes seconds per pin
- How it feels: mostly pressure and a pulling sensation. Taking a simple painkiller beforehand, if your doctor agrees, can help
- Buried pins under the skin need a small procedure with local anesthetic instead
- Afterward: small bandages over the holes, which heal in a few days. Keep them dry for a day or two
After the pins come out
- The bone is healing, not fully healed. A protective splint is often continued for a few more weeks. See finger gutter splints and gutter splints
- Stiffness is common in joints that were held still. Therapy usually starts or steps up now. See stiff hand after a cast or surgery
- Heavy grip and contact sport usually wait until around eight to twelve weeks after surgery
Call your surgeon if
- A pin moves, backs out, bends or disappears under the skin
- You see signs of infection around a pin
- The finger crosses its neighbor when you make a fist
- Fingers are pale, cold, blue or numb
Dry, covered, untouched until removal day, then get the joints moving.
Every article on this site is written using the Closing Window Method: name the window your condition runs on, find where you are in it, and act while it’s still open.