title: Early asymptomatic intrathoracic migration of a threaded pin after proximal humeral osteosynthesis.
abstract: Pinning with metallic wires is a suitable therapeutic option for proximal humeral fractures. Loosening and migration of such devices from this site is uncommon. Despite infrequently occurring, however, the literature reports dramatic and potentially lethal complications related to wires dislocation. A 69-year-old woman underwent closed reduction and fixation of a proximal 3-part humeral fracture by mean of two retrograde Kirschner wires and one anterograde threaded pin. One month after surgery, during a routine follow-up control, it was diagnosed the migration of the threaded pin in the left lung parenchyma. In the meantime, the only symptom the patient complained was an episodic intercostal pain of mild intensity, with referred onset 1 week after surgery. The migrated pin was removed through thoracoscopic approach in the emergency setting, without intra- or post-operative complications. Only a few authors reported similar complications after fixation of proximal humeral fractures. Immediate surgical removal of the device is always mandatory. When considering pinning fixation for shoulder girdle's fractures, orthopedic surgeons should take into account the risk for wire dislocation, and take up adequate precautions during surgery and follow-up control visits.
authors.affiliation: Department of Orthopaedics and Traumatology, University of Genova, School of Medicine, Padiglione 40, Largo Rosanna Benzi 10, Genova, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Cerruti
authors.affiliation: GSL, Albenga Orthopedic Center, Santa Maria di Misericordia Hospital, Viale Martiri Della Foce, Albenga, Italy.
authors.forename: Tony
authors.initials: T
authors.lastname: Mangano
authors.affiliation: GSL, Albenga Orthopedic Center, Santa Maria di Misericordia Hospital, Viale Martiri Della Foce, Albenga, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Giovale
authors.affiliation: Department of Orthopaedics and Traumatology, University of Genova, School of Medicine, Padiglione 40, Largo Rosanna Benzi 10, Genova, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Repetto
keywords: Foreign body migration; Kirschner wire; proximal humeral fracture; thoracoscopy; threaded wire