Sananta Panji, Dradjat Respati Suryanto, Julana Rizky, Pandiangan Ray Asaf Hexa, Sukmajaya William Putera, Abduh Muhammad
Orthopaedic and Traumatology Department, Saiful Anwar Hospital, Jalan Jaksa Agung Suprapto No. 2, Klojen, Kota Malang, Jawa Timur, 65112, Indonesia.
Int J Surg Case Rep. 2020;74:192-195. doi: 10.1016/j.ijscr.2020.08.004. Epub 2020 Aug 29.
The use of K-wire (Kirschner wire) in acromioclavicular dislocation was the first trans-articular fixation technique to be described.
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.
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.
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 This method is outdated and should be restricted as much as possible.
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。
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。
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。
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。