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克氏针移入左肺:一例报告

Clavicle Kirschner Wire Migration into Left Lung: A Case Report.

作者信息

Reghine Érica Lofrano, Cirino Caio César Inaco, Neto André Amate, Varallo Fabiana Rossi, Évora Paulo Roberto Barbosa, de Nadai Tales Rubens

机构信息

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

Department of Surgery and Anatomy, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, SP, Brazil.

出版信息

Am J Case Rep. 2018 Mar 21;19:325-328. doi: 10.12659/ajcr.908014.

Abstract

BACKGROUND Kirschner wires are often used to perform osteosynthesis. Migration through tissue of these wires is a rare but well-known occurrence. CASE REPORT A 65-year-old female presented with light intensity pain complaints in the upper left chest area; personal history included left clavicle fracture 20 years ago that was treated surgically with fixation using a K-wire. Chest radiography showed the presence of metallic foreign body in the left pulmonary apex. An exploratory axillary thoracotomy was performed, and the foreign body was extracted by a pneumotomy. CONCLUSIONS To obtain satisfactory results with a K-wire, some peculiarities in their application should be respected. The time from orthopedic surgery of the collarbone to migration into the chest of the metal rod used can vary from one day to nearly 20 years. Although the migration mechanism remains unclear, it is likely that it involves shoulder movements, breathing movements, negative intrathoracic pressure, gravitational force, or local bone resorption. Caution should be exercised when orthopedic pins and wires are used for the fixation of fractures and dislocations of the shoulder girdle. If there is migration of the wire, it should be removed immediately to avoid sudden and fatal complications.

摘要

背景 克氏针常用于进行骨固定。这些针在组织中移位是一种罕见但众所周知的情况。病例报告 一名65岁女性左上胸部区域出现轻度疼痛主诉;个人史包括20年前左锁骨骨折,当时通过使用克氏针固定进行手术治疗。胸部X线检查显示左肺尖存在金属异物。进行了探查性腋路开胸手术,并通过肺切开术取出异物。结论 为了使用克氏针获得满意效果,应注意其应用中的一些特殊之处。从锁骨骨科手术到所用金属棒移入胸部的时间可从一天到近20年不等。虽然移位机制尚不清楚,但可能涉及肩部运动、呼吸运动、胸腔内负压、重力或局部骨质吸收。在使用骨科针和钢丝固定肩带骨折和脱位时应谨慎。如果钢丝发生移位,应立即取出以避免突然和致命的并发症。

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