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肩锁关节脱位复位后克氏针移入胸腔:一例报告并文献复习

Migration of K-wire into the cavum pleura after the reduction of acromioclavicular dislocation, a case report and review of literature.

作者信息

Sananta Panji, Dradjat Respati Suryanto, Julana Rizky, Pandiangan Ray Asaf Hexa, Sukmajaya William Putera, Abduh Muhammad

机构信息

Orthopaedic and Traumatology Department, Saiful Anwar Hospital, Jalan Jaksa Agung Suprapto No. 2, Klojen, Kota Malang, Jawa Timur, 65112, Indonesia.

出版信息

Int J Surg Case Rep. 2020;74:192-195. doi: 10.1016/j.ijscr.2020.08.004. Epub 2020 Aug 29.

DOI:10.1016/j.ijscr.2020.08.004
PMID:32890895
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7481493/
Abstract

INTRODUCTION

The use of K-wire (Kirschner wire) in acromioclavicular dislocation was the first trans-articular fixation technique to be described.

PRESENTATION OF CASE

A 40-years-old man was presented to the emergency room (ER) with shortness of breath. He had a history of acromioclavicular dislocation two years ago, which had been treated using two K-wires and tension band wiring. The plain x-ray revealed left side pneumothorax with K-wire migrated into the left hemithorax. CT scan showed that K-wire migrated into the posterior cavum pleura. A chest tube was then inserted, and the removal of K-wire was performed using thoracoscopic assisted surgery followed by the removal of the remaining K-wire in the left shoulder. Three days post-surgery, the chest tube was removed, and the patient was discharged from the hospital.

DISCUSSION

This technique is easy and cheap, but it can cause lethal complications. K-wire can migrate into the area of vital organs, including the liver, heart, neck lung subclavian artery, and aorta.

CONCLUSION

K-Wire should be used cautiously for treating upper extremity injury, especially acromioclavicular dislocation, due to its lethal complications. This method is outdated and should be restricted as much as possible.

摘要

引言

克氏针在肩锁关节脱位中的应用是最早被描述的经关节固定技术。

病例介绍

一名40岁男性因呼吸急促被送往急诊室。他两年前有肩锁关节脱位病史,当时采用两根克氏针及张力带钢丝进行治疗。胸部X线平片显示左侧气胸,克氏针移入左半胸。CT扫描显示克氏针移入后胸膜腔。随后插入胸腔引流管,并通过胸腔镜辅助手术取出克氏针,接着取出左肩剩余的克氏针。术后三天,拔除胸腔引流管,患者出院。

讨论

该技术操作简单且成本低廉,但可能导致致命并发症。克氏针可能移入重要器官区域,包括肝脏、心脏、颈部、肺、锁骨下动脉和主动脉。

结论

由于克氏针存在致命并发症,在治疗上肢损伤尤其是肩锁关节脱位时应谨慎使用。这种方法已过时,应尽可能限制使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/068e/7481493/f71489ab7bbf/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/068e/7481493/aac12b1a56da/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/068e/7481493/f71489ab7bbf/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/068e/7481493/aac12b1a56da/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/068e/7481493/f71489ab7bbf/gr2.jpg

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Kirschner Wire Migration after the Treatment of Acromioclavicular Luxation for the Contralateral Shoulder - Case Report.对侧肩部肩锁关节脱位治疗后克氏针移位——病例报告
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The SCARE 2018 statement: Updating consensus Surgical CAse REport (SCARE) guidelines.SCARE 2018 声明:更新共识手术病例报告(SCARE)指南。
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Clavicle Kirschner Wire Migration into Left Lung: A Case Report.
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Migration of a Broken Kirschner Wire after Surgical Treatment of Acromioclavicular Joint Dislocation.肩锁关节脱位手术治疗后克氏针折断移位
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Death Due to Intra-aortic Migration of Kirschner Wire From the Clavicle: A Case Report and Review of the Literature.克氏针从锁骨向主动脉内迁移导致死亡:一例报告及文献复习
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Endopelvic migration of a sternoclavicular K-wire. Case report and review of literature.胸骨锁骨 K 型钉内盆腔迁移。病例报告及文献回顾。
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