Kirschner wires are commonly used for hand fracture fixation. There is clinical uncertainty as to whether the wires should be buried beneath the skin or left exposed.

Proposed advantages of buried wires include a reduced risk of infection and early wire removal. However, their removal can be associated with the inconvenience and financial implications of further surgery.


The WIRE Trial aims to answer the question:

Should Kirschner wires be buried or left exposed after hand fracture fixation in adults?

Project outline

  1. Systematic review (completed and published in JPRAS)
  2. National clinical practice and patient surveys (completed and accepted for publication PRS GO)
  3. National service evaluation of patients undergoing K wire fixation of hand fractures (starting Q1 2018)
  4. Application to NIHR RfPB (estimated November 2018)
  5. WIRE RCT (dependent on funding, 2020)

How can I get involved?

As of January 2018, we are recruiting units to contribute to the service evaluation. Please complete the form below.

Responsibilities of a collaborator to be PubMed cited
  • Gain support from your department (e.g. consultant body and hand therapists)
  • Register WIRE-SE (service evaluation) with your NHS Trust
  • Collect data on consecutive patients for one month and follow up data at 3 months
  • Upload anonymised information to REDCap database (5% or lower missing data rate)

Contributing data with a high missing data rate will result in an acknowledgement and certificate rather than PubMed citation.


  • Certificate of involvement will be provided on completion of the project.
  • Pubmed citation on any subsequent publication directly related to these data.
  • Cited as a collaborator on any presentation relating to these data and RSTN website.
  • Option to present local data separately (i.e. local or regional meeting).

  • Systematic review published
    • Clinician survey published
    • National service evaluation
    • Protocol development
    • PPI for definitive trial
    • NIHR RfPB application
    • WIRE RCT
    Sonya Gardiner
    Specialty Registrar in Plastic Surgery, London

    Hawys Lloyd Hughes
    Specialty Registrar in Plastic Surgery, London

    Justin Wormald
    Specialty Registrar in Plastic Surgery, Oxford
    NIHR Academic Clinical Fellow, Oxford

    Fadi Issa
    Clinical Lecturer in Plastic Surgery, Oxford

    Theodore Pezas
    Specialty Registrar in Plastic Surgery, West Midlands

    Abhilash Jain
    Associate Professor in Plastic Surgery, Oxford

    Jeremy Rodrigues
    Specialty Registrar in Plastic Surgery, Oxford
    NIHR Postdoctoral Fellow, Oxford

    Matthew D. Gardiner
    ATP Hand Fellow, Oxford
    Hon Departmental Clinical Lecturer, Oxford

    The WIRE Collaborative (WIRE Surveys) (PubMed cited)
    WIRE Local investigators (in alphabetical order) comprises: Frank Acquaah, Neil Brierley, Shixin Bickerton, Whitney Chow, Juliet Clutton, Samuel Coulson, Pat Crowley, Sarah Jayne Edmondson, Andy Fowler, Michael Gallagher, Sophie Howles, Jonathan Jones, Lubna Khan, Dharini Kulendran, Clare Langley, Robert Manton, Mohamed Mohamed, Lisa Ng, Andrej Salibi, Gujral Sameer, Nic Segaren, Kavita Sharma, Andreas Shiatis, Kathryn Steele, Camilla Jay-Stewart, Cindy Suwito, Amy Tam, Arron Thind, Ryckie Wade, Natasha Wielogorska, Katie Young.
    BAPRAS Clinical Trials Pump Priming Award (£20K)