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

Abstract

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.

Incidence of Intraoperative Cardiothoracic Intervention During Open Surgery Following Acute Posterior Sternoclavicular Joint Injury: A Case Series and Review of the Literature

“…The use of K-wires has largely been abandoned due to potential complications. [26][27][28][29] There is significant variation in hospital policy regarding the use of cardiothoracic backup during open PSCJi procedures. Fournier and colleagues reviewed 125 patients with acute PSCJi dislocations from 6 institutions.…”

“…Khalil et al 6 describe the temporary use of k-wire fixation to allow for vascular repair. The use of K-wires has largely been abandoned due to potential complications 26–29 …”

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

“…However, in our study, the bending wire also experienced migration. 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).…”

Editorial Comment on the Article by A.O. Farion et al. “Migration of a Kirschner Wire Into the Urinary Bladder: A Case Report”

“…В научной литературе имеются описания случаев миграции спиц Киршнера после операций на опорно-двигательном аппарате с развитием осложнений со стороны внутренних органов [1,2,3].…”