Migration of a Kirschner wire into the spinal canal after acromioclavicular joint repair (case report)
Introduction Fixation of the acromioclavicular joint with Kirschner wires (K-wire) has been widely used by orthopeadic and trauma surgeons in the recent past. Now the technique is less common. Migration of Kirschner wires is a common complication being limited to the fixation area in the majority...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Russian Ilizarov Scientific Center for Restorative Traumatology and Orthopaedics
2023-08-01
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| Series: | Гений oртопедии |
| Subjects: |
| Summary: | Introduction Fixation of the acromioclavicular joint with Kirschner wires (K-wire) has been widely used by orthopeadic and trauma surgeons
in the recent past. Now the technique is less common. Migration of Kirschner wires is a common complication being limited to the fixation area
in the majority of cases and can be a devastating event in rare cases. The objective was to explore K-wire migration into the spinal canal after
acromioclavicular joint repair. Material and methods A clinical case of a broken K-wire migrated into the spinal canal is reported. An unsystematized
literature analysis on the topic was performed. Results and discussion A routine examination revealed a K-wire fragment migrated into the spinal
canal at the cervical level 7 years after acromioclavicular joint fixation in a 36-year-old man. The pin fragments were removed from the spinal
canal and from the acromioclavicular joint site. The postoperative period was uneventful. A good clinical result was obtained, the wounds healed
by primary intention. Migration of K-wires into the spinal canal is a rare but severe complication that can lead to injury to the dura mater, the spinal
cord and the vertebral artery. There are cases of wire migration reported outside the insertion site: into the lung, mediastinum, esophagus, spleen,
intestines, aorta, and heart with the timing of wire migration ranging from 11 days to 12 years of surgery. Conclusion The case report and literature
review have shown a risk of K-wire migration into the spinal canal when used for fractures and dislocations. The technique requires dynamic
observation of the patient throughout the treatment period. The pins should be removed after fracture healing or dislocation repair. The manipulations
can minimize the risk of a fracture and migration of the K-wire s. |
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| ISSN: | 1028-4427 2542-131X |