Forgotten Kirschner wire passing across the sigmoid colon

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.

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

Although Kirschner (K)-wire is among the most commonly used implants in orthopedic surgeries, the migration of this material is a very rare complication. In this article, we present the case of a K-wire migration four years after the surgery detected during the routine control of a 10-year-old male patient who underwent surgical treatment due to the diagnosis of developmental hip dys- plasia on the cerebral palsy. The aim of this study was to raise the awareness regarding this complication particularly for the pediatric orthopedic surgeons, and to recommend the removal of the K-wire as soon as bone union occurs.

Unusual migration of a Kirschner wire in a patient with Osteogenesis Imperfecta: A case report

RATIONALE

Kirschner wires (K-wires) are the most commonly used implants in orthopedic surgery. Although complications are not uncommon, they are mostly benign in nature and easily managed. While migration of K-wires is a rare complication, fatal outcomes have been reported. A review of the literature showed that only 7 cases of wire migration in the hip and pelvic region have been reported. Only 2 occurred in the pediatric population. Although K-wires are routinely used in osteogenesis imperfecta (OI) patients, there has been no report of complications in this vulnerable patient population.

PATIENT CONCERNS

A 10-year-old girl with OI, presenting with gastrointestinal symptoms 1 year after operative fixation of a subtrochanteric femoral fracture. Pelvic x-ray showed a missing K-wire.

DIAGNOSIS

The patient was diagnosed with migration of a K-wire from the left femoral neck to the right retroperitoneal space.

INTERVENTIONS

The patient underwent surgery. During the operation, the migrated K-wire was extracted from just below the 12th rib on the right side.

OUTCOMES

The patient had an uneventful rehabilitation, recovered completely, and was asymptomatic at 2-year follow-up.

LESSONS

There has been no prior report of migrated K-wires in the OI population. This is also the first report of a K-wire migrating from the femoral neck to the contralateral retroperitoneal region. Proper intraoperative bending of K-wires, timely removal of temporary K-wires, and considering K-wire migration in patients with retained hardware complaining of respiratory or gastrointestinal symptoms will prevent potentially life-threatening complications.