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Intracardic migration of Kirschner wire from the right sternoclavicular joint: a case report
Peng Wang1, Cong Chen1, Bo Liu1
1Department of Spine Surgery, Weihai Municipal Hospital, Shandong University, Weihai, Shandong, China.
Insights
Intracardiac migration of Kirschner wires is a rare but serious complication. Prompt removal of migrated wires is crucial to prevent severe health issues and ensure patient recovery.
Area of Science:
- Orthopedic Surgery
- Cardiovascular Complications
- Medical Device Safety
Background:
- Intracardiac wire migration is an infrequent complication following orthopedic procedures.
- Kirschner wires, used for fracture fixation, can migrate and lead to serious adverse events.
Observation:
- A 55-year-old male presented with chest pain and dyspnea 5 months after sternoclavicular joint fixation with a Kirschner wire.
- Computed tomography revealed the Kirschner wire within the pericardium, adjacent to the aorta and right ventricle.
- The patient underwent successful surgical removal of the wire via median sternotomy without cardiopulmonary bypass.
Findings:
- The migrated Kirschner wire was successfully removed, resolving the patient's symptoms of dyspnea and chest pain.
- The patient experienced an uncomplicated recovery post-surgery.
- Early detection and intervention prevented severe complications associated with the migrated wire.
Implications:
- Kirschner wires require judicious use in amphiarthrosis due to risks of breakage and migration.
- Intracardiac wire migration should be considered in patients with chest symptoms post-Kirschner wire surgery.
- Regular follow-up and timely removal of fixation wires are recommended to mitigate migration risks.
Background:
Migration of wires and pins within the heart is an uncommon complication. Intracardic migration of Kirschner wire can cause several complications.
Case Presentation:
A 55-year-old male patient was admitted to the emergency service with dyspnea, stabbing chest pain. The patient's medical history showed that he had undergone a fixation operation using Kirschner wire and plate for treatment of the right sternoclavicular joint dislocation about 5 months prior. Chest computerized tomography revealed a metallic foreign body locating in the pericardium between the aorta and the right ventricle. There were not any serious complications occurred before operation due to the timely detection of potential risks. Removal of the wire was performed via median sternotomy under general anesthesia without cardiopulmonary bypass. The symptoms of dyspnea and chest pain were relieved after surgery, and the patient recovered without any complications.
Conclusion:
The Kirschner wire should be used judiciously in amphiarthrosis in orthopedic surgery for the risk of breakage and migration. The possibility of intracardiac migration of wire should be considered when chest symptoms presenting after surgery with the Kirschner wire. Migrated wires must be removed immediately to prevent serious complications. Regular follow-up and early removal of fixation wires are recommended to prevent migration of wires.
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