Migration of intra-articular K-wire into the contralateral pelvis after surgery for developmental dysplasia of the hip: a case report

Abstract

Transarticular fixation of femoral head into acetabulum with K-wire is a seldomly used surgical method in difficult cases of developmental dysplasia of the hip (DDH). This paper presents a child with intrapelvic transvesicular migration of a K-wire without any symptoms after treatment of DDH. Eight years old girl who had multiple surgeries 4 years ago due to bilateral DDH applied to the orthopedics clinic with limping. She had good range of motion of both hips. At the pelvis radiograph, there was an intrapelvic K-wire standing between two hemipelvises like a bridge. She did not have any enteral and urological symptoms after the previous operations. We planned to remove the K-wire in cooperation with the pediatric surgery department. On the cystoscopy, K-wire was seen passing through the urinary bladder. Wire was cut at the middle point and taken out of the body by laparotomy. The patient was discharged without any postoperative complications. K-wire retention in the body has high chance of migration. Early postoperative removal of the K-wire is necessary to prevent possible complications.

Retroperitoneal Kirschner wire migration after surgical treatment in a patient with cerebral palsy

“…[3] In the last case report study about K-wire migration, Şahin and Karakaş [6] reported that they found K-wire migration in three cases after pelvic osteotomy surgery in pediatric patients. Yurtcu et al [4] and Marya et al [5] reported that this complication can be prevented by tilting the K-wire outside the skin. Firoozabadi et al [13] further suggested that the migration complication can be prevented by the K-wire bending technique they described.…”

“…[3] To the best of our knowledge, there have been only a few reports in the pediatric population with late-term migration of pelvic K-wire. [3][4][5][6] In this case report of a patient with spastic type cerebral palsy sequel, following surgical treatment of developmental hip dysplasia, we presented the migration of the K-wire used in the stabilization of pelvic osteotomy, in the psoas muscle at the retroperitoneal region. The aim of the study was to call attention to the risk of K-wire migration in pediatric population.…”

Unusual migration of a Kirschner wire in a patient with Osteogenesis Imperfecta

“…Interestingly, both cases include transarticular K-wires supporting the reduction in developmental dysplasia of the hip. Yurtçu et al [ 8 ] report a case of transvesical pin migration after surgery for developmental dysplasia of the hip. Marya et al report a 5-year-old child, in which a transarticular K-wire, placed out of the skin during surgery, could not be found upon cast removal.…”

Migration of a Kirschner wire to the dorsolateral side of the foot following osteosynthesis of a patella fracture with tension band wiring: a case report

“…Longitudinal and lung migrations of the wire after the fixation of acromioclavicular and clavicle fractures are among the most frequently reported cases after migration following proximal humeral fracture fixation [ 9 , 10 ]. Similarly, wire migration to the pelvis is among the complications reported after temporary transacetabular K-wire fixation to prevent dislocation during the cast winding process in developmental dysplasia of the hip [ 11 ]. It is possible for small, unnoticed wire fragments to remain in the tissue following wire removal and to be carried to distant regions, especially to the heart, after they penetrate the blood vessels [ 12 ].…”