Bezer Murat, Aydin Nuri, Erol Bülent, Laçin Tunç, Güven Osman
Department of Orthopedics and Traumatology, Marmara University School of Medicine, Istanbul, Turkey.
Ulus Travma Acil Cerrahi Derg. 2009 May;15(3):298-300.
The migration of various internal fixation devices, especially Kirshner (K) wires, is well established. The wires usually follow a retrograde path, protruding near the entry point. When they migrate in the other direction, serious problems may occur. Migration of K-wires to the lung, heart, spleen, subclavian artery, pulmonary artery and aorta have been reported in a few cases. A 26-year-old male with chest pain was seen in our clinic. The patient had been operated for left distal clavicle fracture two years before. No abnormality was noted on the physical examination. Radiographs showed migration of the wire outside the clavicle across the sternum to the opposite hemithorax. The pin was removed through the incision over the sternum under direct vision with thoracoscope. The pin was extrapleurally located. There was no additional morbidity attributed to thoracoscopy or chest tube. In conclusion, K-wires can easily migrate, resulting in serious complications. Close follow-up should be done after internal fixation.
各种内固定装置的移位,尤其是克氏针,已得到充分证实。这些针通常会逆行移位,在进针点附近突出。当它们向相反方向移位时,可能会出现严重问题。少数病例报告了克氏针移位至肺、心脏、脾脏、锁骨下动脉、肺动脉和主动脉。我们诊所接诊了一名26岁胸痛男性患者。该患者两年前因左锁骨远端骨折接受了手术。体格检查未发现异常。X线片显示克氏针从锁骨外侧穿过胸骨移位至对侧胸腔。在胸腔镜直视下通过胸骨上的切口取出了克氏针。克氏针位于胸膜外。胸腔镜检查或胸管未导致额外的并发症。总之,克氏针容易移位,导致严重并发症。内固定后应密切随访。