CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2019; 54(02): 202-205
DOI: 10.1016/j.rbo.2017.09.017
Case Report | Relato de Caso
Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revnter Publicações Ltda Rio de Janeiro, Brazil

Kirschner Wire Migration after the Treatment of Acromioclavicular Luxation for the Contralateral Shoulder – Case Report[*]

Article in several languages: português | English
Fabiano Rogerio Palauro
1   Departamento de Ortopedia e Traumatologia, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brasil
,
Guilherme Augusto Stirma
1   Departamento de Ortopedia e Traumatologia, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brasil
,
Armando Romani Secundino
1   Departamento de Ortopedia e Traumatologia, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brasil
,
Gabriel Bonato Riffel
1   Departamento de Ortopedia e Traumatologia, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brasil
,
Filipe Baracho
1   Departamento de Ortopedia e Traumatologia, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brasil
,
Leonardo Dau
1   Departamento de Ortopedia e Traumatologia, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brasil
› Author Affiliations
Further Information

Publication History

31 July 2017

13 September 2017

Publication Date:
15 April 2019 (online)

Abstract

The use of metal wires, called Kirschner wires, is a simple and effective fixation method for the correction of shoulder fractures and of dislocations in orthopedic surgery. Wire migration during the postoperative follow-up is a possible complication of the procedure. The authors present the case of a 48-year-old male patient, a business administrator, who suffered a fall from his own height during a soccer match resulting in right shoulder trauma. The patient was treated at a specialized orthopedics and trauma hospital and was diagnosed with a grade V acromioclavicular dislocation. Four days after the trauma, the acromioclavicular dislocation was surgically treated using ligatures with anchor wires, coracoacromial ligament transfer, and fixation with Kirshner wires from the acromion to the clavicle. At the follow-up, 12 days after the surgical procedure, migration of the Kirschner wire to the acromion edge was identified. The patient was oriented to undergo another surgery to remove the Kirshner wire, due to the possibility of further migration; nonetheless, he refused the surgery. Nine months after the surgical treatment, the patient complained of pain on the left shoulder (contralateral side), difficulty to mobilize the shoulder, ecchymosis, and protrusion. Bilateral radiographs demonstrated that the Kirschner wire, originally from the right shoulder, was on the left side. The patient then underwent a successful surgery to remove the implant.

* Work developed at the Departamento de Ortopedia e Traumatologia, Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil.


 
  • References

  • 1 Tan L, Sun DH, Yu T, Wang L, Zhu D, Li YH. Death due to intra-aortic migration of Kirschner wire from the clavicle: a case report and review of the literature. Medicine (Baltimore) 2016; 95 (21) e3741
  • 2 Lyons FA, Rockwood Jr CA. Migration of pins used in operations on the shoulder. J Bone Joint Surg Am 1990; 72 (08) 1262-1267
  • 3 Batın S, Ozan F, Gürbüz K, Uzun E, Kayalı C, Altay T. Migration of a broken Kirschner wire after surgical treatment of acromioclavicular joint dislocation. Case Rep Surg 2016; 2016: 6804670
  • 4 Fransen P, Bourgeois S, Rommens J. Kirschner wire migration causing spinal cord injury one year after internal fixation of a clavicle fracture. Acta Orthop Belg 2007; 73 (03) 390-392
  • 5 McCaughan Jr JS, Miller PR. Migration of Steinmann pin from shoulder to lung. JAMA 1969; 207 (10) 1917
  • 6 Mazet R. Migration of a Kirschner wire from the shoulder region into the lung: report of two cases. J Bone Joint Surg. 1943; 25 (02) 477-483
  • 7 Ballas R, Bonnel F. Endopelvic migration of a sternoclavicular K-wire. Case report and review of literature. Orthop Traumatol Surg Res 2012; 98 (01) 118-121
  • 8 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 (02) 155-156
  • 9 Venissac N, Alifano M, Dahan M, Mouroux J. Intrathoracic migration of Kirschner pins. Ann Thorac Surg 2000; 69 (06) 1953-1955