Intra-articular Migration of Broken Patellar Tension Band Wire: A Rare Case
Satish Kumar Sharma1, Sonendra Kumar Sharma1, Mohammed Aslam1
1Department of Orthopaedics, Sir Ganga Ram Hospital, New Delhi, India.
Introduction:
Comminuted fracture of patella is most commonly treated by tension band wiring with cerclage wiring. Broken cerclage wiring after such surgery is not uncommon but intra-articular migration of broken cerclage wire is rarely known and described complication.
Case Report:
A 51-year-old male patient of Indian origin which was treated, 15 months back for fracture patella with tension band wiring with cerclage wiring, presented with painful restriction of knee movements for the last 4 weeks. X-ray showed cerclage wire had broken at multiple sites with one broken piece migrated intra-articular. This case is unique due to the size of migrated broken cerclage wire which was about 4.5 cm long, second the anterior part of broken wire was hooked around anterior cruciate ligament, which prevented its further migration otherwise neurovascular structures could have been damaged. This intra-articular piece of wire was removed arthroscopically.
Conclusions:
We recommend that all patients receiving bone fixation with wires should be counseled about the risks of hardware failure and possible migration, with the option of elective hardware removal discussed. In addition, when wire breakage is detected radiologically, the patient should be strongly advised to have the wires removed as soon as possible.
