Abstract
We report a case of early intrathoracic migration of Kirshner wire (K-wire), which had been-used for fixation of proximal humerus fracture. A 74 year-old-woman visited the emergency room due to sudden onset of dyspnea. A chest x-ray and CT scan taken at the emergency room demonstrated 3 K-wires that had been applied to the proximal humerus fracture, 1 K-wire in the anterior chest wall, and mild pneumothorax of the right lung. An emergency removal of K-wire using thoracoscopy was performed and a chest tube was inserted for the treatment of pneumothorax during thoracic surgery. We removed residual 3 K-wires from the right proximal humerus and fixed right proximal humerus fracture by open reduction and internal fixation using a proximal humerus locking plate. We think that if a proximal humerus fracture is fixed using smooth K-wire, patients require close follow-up with the use of x-ray until the K-wire has been removed, in addition, it is very important to take steps to prevent K-wire migration.
References
1. Mazet R Jr. Migration of a kirschner wire from the shoulder region into the lung: report of two cases. J Bone Joint Surg Am. 1943. 25:477–483.
2. Lyons FA, Rockwood CA Jr. Migration of pins used in operations on the shoulder. J Bone Joint Surg Am. 1990. 72:1262–1267.
3. Fuster S, Palliso F, Combalia A, Sanjuan A, Garcia S. Intrathoracic migration of a Kirschner wire. Injury. 1990. 21:124–126.
4. Freund E, Nachman R, Gips H, Hiss J. Migration of a Kirschner wire used in the fixation of a subcapital humeral fracture, causing cardiac tamponade: case report and review of literature. Am J Forensic Med Pathol. 2007. 28:155–156.
5. Mellado JM, Calmet J, García Forcada IL, Saurí A, Giné J. Early intrathoracic migration of Kirschner wires used for percutaneous osteosynthesis of a two-part humeral neck fracture: a case report. Emerg Radiol. 2004. 11:49–52.
6. Sergides NN, Nikolopoulos DD, Yfadopoulos DK, Novi EA, Kanata MP. Intrathoracic migration of a Steinman wire: a case report and review of the literature. Cases J. 2009. 2:8321.
7. Rowe SM, Lee WS. Migration of metal fixatives from the acromioclavicular joint into the neck (report of two cases). J Korean Orthop Assoc. 1986. 21:499–501.
8. Ha SH, You JW, Lee SH, Shin DM, Pyo YB. Migration of kirschner-wires from the acromioclavicular joint into the neck: report of 2cases). J Korean Orthop Assoc. 1994. 29:1264–1267.