ABSTRACT
We report an unusual case of Kirschner wire migration from the proximal humerus into the thoracic cavity and diaphragm which induced pneumothorax and hemoperitoneum. An 81-year-old woman admitted to the emergency room due to sudden onset of dyspnea. X-rays showed pneumothorax and old proximal humerus fracture fixed with rush pins and K-wires. One of K-wires was seen on the diaphragm level at posterior gutter of chest wall. Through the abdomen, K-wire was removed from the diaphragm and a chest tube was inserted. The potential for K-wires to migrate must be recognized, and frequent postoperative radiographic studies have to be performed for the early detection of loosening and migration. It appears that if K-wires are used for fixation of proximal humerus, the lateral ends must be bent to prevent medial migration, and when the desired therapeutic goals have been achieved, these pins have to be susbsequently removed as soon as possible.
Subject(s)
Aged, 80 and over , Female , Humans , Abdomen , Chest Tubes , Diaphragm , Dyspnea , Emergency Service, Hospital , Hemoperitoneum , Humerus , Pneumothorax , Thoracic Cavity , Thoracic WallABSTRACT
Kirschner-wires and pins are used for the intenal fixation of the acromioclavicular joint. Many surgeons are aware of the tendency of these appliances to migrate, however, few reports of this complication have appeared in literature. This report concerns two instances of migration K-wires from the acromioclavicular joint into the neck, The potential for K-wires to migrate must be recogniged, and more frequent postoperative radiographic studies performed after the insertion of such pins to permit earlier detection of bony resorption and migration. Thereby permitting earlier removal. In cases of young adult, the wires must be removed as soon as the desired theurapeutic results have been obtained.