Migration of a K-wire from the distal radius to the heart.
K-wires and Steinmann pins are used to provide internal fixation for fractures or osteotomies. In some instances, removal of the implant is planned and the implant is left long to facilitate its removal. In other instances, implant removal is not planned and the implant is cut off at the level of the bone. Migration of these implants to solid organs or body cavities has been reported. Extravascular migration may occur along tissue planes assisted by muscle motion. Large vessel penetration can occur and has been reported with subsequent migration of the implant to the heart. This case report documents the loosening of a K-wire used in the distal radius to supplement the fixation of a complex intra-articular fracture, migration of the implant along tissue planes, penetration into a peripheral vein, and continued migration of the implant to the heart. There are multiple reports documenting wandering bullets, venous catheter tips, and invasive monitoring devices in the extremities. This is only the second case report that the authors are aware of that confirms migration of an implant from the distal extremity to the heart.
Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, USA.
R C
RC
Seipel
G J
GJ
Schmeling
R A
RA
Daley
D000437:Alcoholism; D001864:Bone Wires / Q000009:adverse effects*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002637:Chest Pain / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D006321:Heart; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011885:Radius Fractures / Q000175:diagnosis / Q000601:surgery*; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome