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Orthotopic Left Lung Transplantation in Rats
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Clavicle Kirschner Wire Migration into Left Lung: A Case Report.

Érica Lofrano Reghine1, Caio César Inaco Cirino1, André Amate Neto1

  • 1Américo Brasiliense State Hospital, São Paulo, SP, Brazil.

The American Journal of Case Reports
|March 22, 2018
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Summary

Kirschner wires (K-wires) used in bone fixation can migrate through tissue, posing a rare risk. This case highlights a K-wire migrating into the lung nearly 20 years after clavicle surgery, emphasizing removal to prevent complications.

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Area of Science:

  • Orthopedic Surgery
  • Thoracic Surgery
  • Radiology

Background:

  • Kirschner wires (K-wires) are commonly employed for osteosynthesis, particularly in orthopedic procedures.
  • While generally safe, K-wire migration through surrounding tissues is a recognized, albeit infrequent, complication.
  • This phenomenon necessitates careful consideration of surgical techniques and patient monitoring.

Observation:

  • A 65-year-old female presented with left upper chest pain, reporting a clavicle fracture treated surgically with a K-wire 20 years prior.
  • Chest radiography revealed a metallic foreign body within the left pulmonary apex.
  • Surgical intervention via axillary thoracotomy and pneumotomy was performed for foreign body extraction.

Findings:

  • The case illustrates a delayed K-wire migration into the thoracic cavity, occurring almost two decades after initial clavicle fracture fixation.
  • The exact mechanism of migration remains elusive, but potential factors include biomechanical forces (shoulder/breathing movements, negative intrathoracic pressure, gravity) and local bone resorption.
  • The time interval between orthopedic surgery and K-wire migration can range significantly, from days to years.

Implications:

  • Judicious application of K-wires, adhering to specific procedural nuances, is crucial for optimal osteosynthesis outcomes.
  • Close monitoring and prompt removal of migrated K-wires are essential to avert potentially fatal intrathoracic complications.
  • Enhanced vigilance is warranted when utilizing orthopedic pins and wires for shoulder girdle fracture fixation.