[Kirschner wire migration in the contralateral lung after osteosynthesis of a clavicular fracture].
A 59-year-old patient was admitted complaining breathing-dependent pain in the lower right chest and increasing dyspnoea. Diminished breath sounds in the right lung and dullness in the lower right chest were found. Chest x-ray and complementary CT scan showed an intrapulmonary Kirschner wire and a large haematothorax but no pneumothorax. At 6 weeks before admission, the patient suffered a fracture of the medial left clavicle which was treated by closed reduction and percutaneous osteosynthesis with two Kirschner wires. The migrated K-wire and the haematoma were removed by video-assisted thoracoscopy without complications. Migration of Kirschner wires after clavicle fracture osteosynthesis is rare but dangerous. Migrations into the heart, lung, pulmonary vein or the cervical spinal cord have been recorded. Patients with K-wire osteosynthesis should be informed of the risk of wire migration and should undergo regular postoperative follow-ups including radiography every 2-4 weeks.
Abteilung für Anästhesie und operative Intensivmedizin, Paracelsus-Klinik der Stadt Marl. h.holthusen@paracelsus-klinik-marl.de
S
S
Hegemann
R
R
Kleining
H G
HG
Schindler
H
H
Holthusen
D001864:Bone Wires / Q000009:adverse effects*; D002968:Clavicle / Q000293:injuries / Q000601:surgery; D020878:Device Removal; D005548:Foreign-Body Migration / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000009:adverse effects*; D006491:Hemothorax / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012784:Shoulder Fractures / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome