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2006, Number 2

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Rev Inst Nal Enf Resp Mex 2006; 19 (2)

Migration of a Kirschner wire to the mediastinum

García TR, Ramírez VFA, Vásquez FF, Prieto MEG
Full text How to cite this article

Language: Spanish
References: 11
Page: 127-130
PDF size: 146.06 Kb.


Key words:

Complications, foreign body, Kirschner wire, mediastinum, migration, orthopedic surgery, pulmonary artery, thoracic surgery.

ABSTRACT

Introduction: Metallic implants, as the Kirschner wire are commonly used in orthopedics. They can migrate and produce various and potentially severe complications.
Clinical case: An 86 year old woman had a chronic luxation of the right shoulder treated by internal fixation with a 17.3 cm Kirschner wire. She was asymptomatic when seen six months later at the outpatient clinic; the chest X ray and CT scans showed the Kirschner wire crossing through the mediastinum, from right to left, perforating both lungs and the left pulmonary artery, in close vicinity to the aorta, the esophagus and a vertebral body. The wire was removed through a left posterolateral thoracotomy producing a laceration of the left pulmonary artery that was repaired with 5-0 vascular sutures. She is doing well.
The pertinent literature is reviewed.


REFERENCES

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  2. Goodsett JR, Pahl AC, Glaspy JN, Schapira MM. Kirschner wire embolization to the heart: an unusual cause of pericardial tamponade. Chest 1999;115;291-293.

  3. Haapaniemi TA, Hermansson US. Cardiac arrhythmia caused by a Kirschner wire inside the heart. An unusual complication of finger osteosynthesis. J Hand Surg (Br) 1997;22;402-404.

  4. Potter FA, Fiorini AJ, Knox J, Rajesh PB. The migration of a Kirschner wire from shoulder to spleen: brief report. J Bone Joint Surg Br 1988;70:326-327.

  5. Rajesh PB, Nair KK. Unusual migration of a Kirschner wire. Eur J Cardiothorac Surg 1991;5;164.

  6. Anic D, Brida V, Jelic I, Orlic D. The cardiac migration of a Kirschner wire. A case report. Tex Heart Inst J 1997;24:359-361.

  7. Wada S, Noguchi T, Hashimoto T, Uchida Y, Kawahara K. Successful treatment of a patient with penetrating injury of the esophagus and brachiocephalic artery due to migration of Kirschner wires. Ann Thorac Cardiovasc Surg 2005;11:313-315.

  8. Foster GT, Chetty KG, Mahutte K, Kim JB, Sasse SA. Hemoptysis due to migration of a fractured Kirschner wire. Chest 2001;119:1285-1286.

  9. Regel JP, Pospiech J, Aalders TA, Ruchholtz S. Intraspinal migration of a Kirschner wire 3 months after clavicular fracture fixation. Neurosurg Rev 2002; 25:110-112.

  10. 10.Liu HP, Chang CH, Lin PJ, et al. Pulmonary artery perforation after Kirschner wire migration: a case report and review of the literature. J Trauma 1993; 34:154-156.

  11. 11.Nordback I, Markkula H. Migration of Kirschner pin from clavicle into ascending aorta. Acta Chir Scand 1985;151:177-179.




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Rev Inst Nal Enf Resp Mex. 2006;19