Heart embolization with the Kirschner wire without cardiac tamponade

Broken Kirschner Wires Can Migrate: A Case Report and Review of Literature

Introduction

Kirschner wires are in use in orthopedic and trauma surgery since the past 80 years. These wires can break due to metal fatigue and migrate which can cause lethal complications.

Case Report

A 27-year-old female sickle cell patient with avascular necrosis of the head of femur, drilling, and injection of the osteoblasts in the head of femur was being performed. A 2 cm of 2.0 mm proximal tip of the guide wire broke. Discussion started whether to leave the wire and the young decided to leave the broken wire, but the wisdom directed us to remove it.

Conclusion

Migration of wires does occur, we believe not only broken wires should be removed but also even the unbroken wire to be removed once the purpose of use is achieved.

External Iliac Artery-Appendicular Fistula due to Antegrade Unusual Migration of K-Wire from Hip to Pelvis: An Unreported Complication

Background. K-wires are thought to be extremely safe implants and complications as a result of direct insertion or migration are very rare. Complications may be life-threatening in some instances where migration results in injury to vital organs. We report one such case where antegrade migration of K-wire from the hip resulted in injury to external iliac artery and formation of external iliac artery-appendicular fistula. No such complication due to migration has ever been reported in the literature. Case Description. A 15-year-old boy presented with lower abdominal pain, right lower limb swelling and pain, inability to walk, and rectal bleeding for 1 month after 2 K-wires had been inserted in his right hip joint for treatment of slipped capital femoral epiphysis the previous year. On investigation, he was diagnosed to have external iliac artery-appendicular fistula for which he was surgically treated. Clinical Relevance. Antegrade migration of K-wire from hip joint may lead to life-threatening injuries which can be minimized by bending the end of the K-wire, keeping the tip protruding outside the skin wherever possible and by early removal of K-wire once its purpose has been achieved.

Removal of an intra-abdominal Kirschner wire under digital subtraction angiography: a pediatric case report

Intra-abdominal migration of Kirschner wire is unusual in children. We present a case of intra-abdominal migration of Kirschner wire used for stabilization of the hip joint during pelvic osteotomy, and its successful removal under digital subtraction angiography.

Endopelvic migration of a sternoclavicular K-wire. Case report and review of literature

We report a unique case, never before published, of sternoclavicular joint fixation K-wire migration to the pelvic region, in a 56 year-old man. Two years previously, sternoclavicular dislocation had been fixed by three wires. A transitory episode of precordial thoracic pain followed by iterative abdominal pain accompanied the migration. Extraction was performed five years later. Scapular K-wire migration is frequent. The proximity of cardiovascular structures may have fatal consequences. This type of internal fixation raises questions, and migration prevention needs to be taken into account. Medical complications and the legal context are major factors leading us to abandon this type of osteosynthesis. Once migration has been diagnosed, the wire should be removed without delay.

Frequency of instrument breakage during orthopaedic procedures and its effects on patients

BACKGROUND

While breakage of an orthopaedic instrument is a relatively rare occurrence, orthopaedic surgeons need to be familiar with this complication and how to deal with it. Relatively little information about this subject has been published.

METHODS

Every case of instrument breakage during orthopaedic procedures performed in two hospitals during a two-year period was documented prospectively. All patients were followed for a postoperative period ranging from twelve to thirty-six months, during which radiographs in two planes were made to assess changes in, or migration of, the broken object.

RESULTS

During the observation period, 11,856 surgical procedures were performed in the two hospitals. The overall rate of instrument breakage was 0.35%. The broken piece was removed in five cases, and the broken instrument was left in situ in thirty-seven cases. During the follow-up period, none of the patients had any symptoms.

CONCLUSIONS

In most cases, breakage of an orthopaedic instrument is not a problem. Any instance of instrument breakage should be fully documented in the surgical report.

Migration of a Kirschner wire to the heart in a Yorkshire terrier

A 12-year-old, male Yorkshire terrier was presented for acute pulmonary oedema. Thoracic radiographs showed a linear metallic foreign body within the cardiac silhouette. Echocardiogram showed a hyperechoic line extending through the left ventricle, the mitral valve, leading into the left atrium. A 4 cm long Kirschner wire was surgically removed by left fourth thoracotomy. The dog died two days after surgery for acute pulmonary oedema. Necropsy showed thrombi on the mitral leaflets that impeded their movement.