Intraspinal migration of a Kirschner wire 3 months after clavicular fracture fixation.
The authors describe a patient who had Kirschner (K-) wire osteosynthesis of a right lateral clavicular fracture and developed a tetraparesis after 3 months. Plain X-ray and CT scan showed an intraspinal migration of one K-wire through the intervertebral foramen of C5/6. The K-wire was pulled out through an opening of the wound over the right clavicle. No CSF fistula was seen. The patient recovered without any postoperative neurological deficit. Patients with K-wire osteosynthesis should be informed about the risk of dislocation and wandering and should regularly be seen in the outpatient clinic. Regular X-rays should be performed. The K-wires must be sufficiently bent at the distal end to prevent wandering into the proximal direction. The K-wires should be removed soon after 6 weeks and, in cases of dislocation and migration, as early as possible.
Regel
Jens P
JP
Department of Neurosurgery, University of Essen Medical School, Germany. jenspr@aol.com
Pospiech
Josef
J
Aalders
Thomas A
TA
Ruchholtz
Steffen
S
D001864:Bone Wires / Q000009:adverse effects*; D002968:Clavicle / Q000293:injuries*; D005548:Foreign-Body Migration / Q000175:diagnosis; D005592:Fracture Fixation / Q000295:instrumentation* / Q000379:methods*; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed