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

Migrated K-wire in the urinary bladder not causing symptoms: A rare case report

INTRODUCTION AND IMPORTANCE

Kirschner wires (K-wires) are commonly used implants in the treatment of bony fracture. The migration of K-wire has been reported in the literature, but such migration into the urinary bladder is extremely rare.

PRESENTATION OF CASE

We report a case of an asymptomatic patient with a migrating K-wire in the urinary bladder, who came to our follow-up clinic after treatment of a hip fracture. The patient was absolutely fine but follow-up image showed K-wire in the urinary bladder. In view to prevent further migration and injuries, the laparotomy was planned and wire has been removed under the C-arm image guidance. Postoperative period was uneventful and patient was discharged.

CLINICAL DISCUSSION

The aim of reporting this case was to spread the awareness about mandatory follow-up after K-wire placement, its migration, and the recommendation to remove it at earliest. As per my best knowledge, this is the first and unique case of K-wire migration into the urinary bladder, detected on follow-up image without symptoms.

CONCLUSION

Bending the end of the K-wires after insertion, the restriction of joint movement, and removal of migrated K-wires at earliest are the key points in a patients with K-wire insertion. The mandatory follow-up in cases of K-wire placement for treatment of bone fracture, and early diagnosis prevent the potentially fatal complications.

Broken pin removal from hip joint using arthroscopic grasper - A technical note and review of literature

Guidewire breakage during a surgical procedure is uncommon but still challenging for orthopedic surgeons. Due to the potential for harmful complications, surgeons prefer to remove broken wires near the joint surface or neurovascular bundle in the hip region. Due to the depth of the location, the retrieval procedure is arduous, time-consuming, and potentially dangerous. This study describes a case of a sub-capital femoral neck fracture that was fixed with a cannulated screw. However, three years later, the distal portion of the guidewire broke and migrated into the hip joint, where it became entrapped. This study describes a method for removing a broken wire from the hip region and a relevant literature review. In brief, initially, we untightened the screw and removed it. Afterward, the broken wire was reached by reaming in the direction of the screw. Ultimately, we advanced the arthroscopic grasper to the broken wire for removal under fluoroscopic guidance. The study's findings indicate that this method could provide a promising outcome with minimal complications.

Guided growth in the correction of knee deformity in patients with congenital insensitivity to pain

Background

Orthopedic manifestations of congenital insensitivity to pain (CIP) can be devastating if left untreated. Knee deformities are common in patients with CIP and might lead to joint destruction and loss of walking ability. The purpose of the present study was to report the results and complications of guided growth procedures around the knee in patients with CIP.

Methods

In a retrospective review, all patients with CIP who underwent guided growth procedures around the knee from 2009 to 2017 at a tertiary referral hospital were evaluated. Patients with secondary insensitivity to pain (e.g., syringomyelia), as well as patients with incomplete records, were excluded. Demographic data, clinical findings, correction rate, and complications were recorded.

Results

Ten knees in six patients fulfilled the inclusion criteria. The median age was 10 (range, 5–12), with a mean follow-up of 31 months (range, 16–56). Distal femoral tension-band hemiepiphysiodesis was the most common procedure, followed by proximal tibial hemiepiphysiodesis. The mean correction rate was 0.28°/month for femoral deformity. Staples were removed prematurely in one patient due to extrusion. No cases of infection or skin dehiscence were observed. None of the patients needed a reconstructive knee procedure during the study period.

Conclusions

The findings of this study suggest that guided growth procedures might have a role in the correction of knee deformities in patients with CIP. However, the correction rate is lower than that of typically developing children, patients should be closely followed to prevent complications, and stringent patient selection criteria should be followed to ensure success.

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.