Asymptomatic Migration of a Kirschner Wire from the Proximal Aspect of the Humerus to the Thoracic Cavity

Pientka, William F.; Bates, Christopher M.

doi:10.2106/jbjs.cc.16.00032

Cited by 3 publications

(3 citation statements)

References 21 publications

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“…This safely assumes that bending the wire solely does not completely prevent the migration since there are many contributing factors, such as high-force movement, gravitational force, intrathoracic pressure, and muscle activity (Wang, et al, 2021). Our patient worked as a mechanic, which required him to do heavy work on his shoulder, so we suggested that a lot of muscle activity and shoulder movement may induce wire migration (Pientka, et al, 2016) Considering the harmful potential of K-wire, X-ray evaluation is also necessary to assess bone healing based on the patient's age and pattern of the injury, which usually takes around 4-6 weeks after surgery unless non-union occurs (Sananta, et al, 2020). Regular radiological follow-up may be needed for patients with foreign bodies at risk of expulsion of vital structures (Tenconi, et al, 2014).…”

Section: Discussionmentioning

confidence: 96%

Spinal K-Wire Migration Following Acromioclavicular Dislocation Surgical Treatment: a Case Report With Scoping Review Discussion

Nizar Al Rhaazi,

Ahmadin Y.R. Susatyo,

Faesal

et al. 2023

MBIOMJ

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Background: Kirschner wire as internal fixation is a common instrument used in any small bone, including on Acromioclavicular Dislocation Surgical Treatment (ADST). Due to the characteristic of the wire, which is less rigid than any other instrument, the wire can sometimes migrate unexpectedly into various locations. Wire migration has been reported sporadically since 1943. However, spinal migration is still underreported. In addition, the mechanism of spinal migration and the evacuation method remains unclear. Objective: The purpose of this study was to report a case of K-wire spinal migration to cervical vertebrae C6-C7 following surgical treatment and discuss the case using the results of a scoping review. Case: A 51 years-old man with wire migration to cervical vertebrae C6-C7 complained of painful sensations around the left side of the neck and left shoulder, which aggravated with shoulder movement. He underwent left acra omioclavicular joint repair surgery three years ago after a motorcycle accident. No other abnormalities were found in either physical or neurological examinations. Discussion: In the last 10 years, six cases of spinal migration after ADST have been reported, with less than one case reported a year. The cases' gender was all male, with a mean age of 43.33 years old. The majority of them underwent acromioclavicular fixation in 50% of cases, and the average time from migration to surgery is 71 months. The most common migration is located in the cervical region (66.67%), and the penetrating points are equal in all cases. In the non-bent wire group, an entire migration has been reported. The evacuation technique used in all previous cases was direct access surgery by gently pulling out the wire along its axis under visual control. Various mechanisms contribute to spinal migration, but shoulder movement is arguably the most influential factor. Conclusion: Cervical migration post-ADST commonly occurs and may cause severe morbidity.

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Section: Discussionmentioning

confidence: 96%

Spinal K-Wire Migration Following Acromioclavicular Dislocation Surgical Treatment: a Case Report With Scoping Review Discussion

Nizar Al Rhaazi,

Ahmadin Y.R. Susatyo,

Faesal

et al. 2023

MBIOMJ

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“…En el caso informado, mediante tomografía se identificó la ubicación intratorácica del clavo de Kirschner, y por lo tanto se decidió realizar la toracoscopia 16,21 . Antes se habían descrito abordajes como la toracotomía y esternotomía 22,23 para la extracción de los dispositivos o los cuerpos extraños alojados en el tórax, bien sea en la pleura o el pericardio, pero ahora el procedimiento de elección es la toracoscopia 21,[24][25][26] , por tener múltiples ventajas sobre la cirugía abierta.…”

Section: Discussionunclassified

Migración intratorácica de clavo Kirschner desde clavícula distal: Presentación de caso y manejo

Méndez-Daza,

Obando-Guerrero,

Zuluaga-Álvarez

et al. 2024

Rev Colomb Cir

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Introducción. Los clavos Kirschner son dispositivos muy utilizados desde su creación para osteosíntesis, especialmente en miembro superior. Entre las complicaciones de su uso, se conoce la migración de estos a diferentes estructuras anatómicas. Caso clínico. Se presenta un paciente de 76 años con fractura de clavícula distal derecha, que fue llevado a cirugía para osteosíntesis con placa, tornillos y 2 clavos Kirschner. Un mes después inició con dolor intenso en hombro y presentó síntomas respiratorios. En la radiografía se encontró migración de uno de los clavos de Kirschner al pulmón ipsilateral. Resultado. Esta complicación fue resuelta mediante toracoscopia, sin complicaciones. Conclusión. La migración de los clavos de Kirschner desde la región del hombro hacia cavidad torácica es una complicación descrita, que debe ser diagnosticada a tiempo. Existe la opción del manejo quirúrgico endoscópico, como en este caso, sin mayor riesgo de complicación.

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“…If the K-wires need to retain to fix fracture or dislocation, it is strongly advocated to bend the wire to prevent migration [ 12 ]. However, there is still a possibility of loosening or breakage of K-wires in the postoperative period due to osteopenia or joint movement [ 13 ]. Rigorous radiography and clinical follow-up every 2–4 weeks must be performed to evaluate bone healing and position of internal fixation.…”

Section: Discussionmentioning

confidence: 99%

Intracardic migration of Kirschner wire from the right sternoclavicular joint: a case report

et al. 2021

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Background Migration of wires and pins within the heart is an uncommon complication. Intracardic migration of Kirschner wire can cause several complications. Case presentation A 55-year-old male patient was admitted to the emergency service with dyspnea, stabbing chest pain. The patient’s medical history showed that he had undergone a fixation operation using Kirschner wire and plate for treatment of the right sternoclavicular joint dislocation about 5 months prior. Chest computerized tomography revealed a metallic foreign body locating in the pericardium between the aorta and the right ventricle. There were not any serious complications occurred before operation due to the timely detection of potential risks. Removal of the wire was performed via median sternotomy under general anesthesia without cardiopulmonary bypass. The symptoms of dyspnea and chest pain were relieved after surgery, and the patient recovered without any complications. Conclusion The Kirschner wire should be used judiciously in amphiarthrosis in orthopedic surgery for the risk of breakage and migration. The possibility of intracardiac migration of wire should be considered when chest symptoms presenting after surgery with the Kirschner wire. Migrated wires must be removed immediately to prevent serious complications. Regular follow-up and early removal of fixation wires are recommended to prevent migration of wires.

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Asymptomatic Migration of a Kirschner Wire from the Proximal Aspect of the Humerus to the Thoracic Cavity

Cited by 3 publications

References 21 publications

Spinal K-Wire Migration Following Acromioclavicular Dislocation Surgical Treatment: a Case Report With Scoping Review Discussion

Spinal K-Wire Migration Following Acromioclavicular Dislocation Surgical Treatment: a Case Report With Scoping Review Discussion

Migración intratorácica de clavo Kirschner desde clavícula distal: Presentación de caso y manejo

Intracardic migration of Kirschner wire from the right sternoclavicular joint: a case report

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