J Korean Orthop Assoc.  2011 Apr;46(2):167-171.

Early Intrathoracic Migration of K-wire Used for Fixation of Proximal Humerus Fracture

• Cheon SJ
• Lee JM

Abstract

We report a case of early intrathoracic migration of Kirshner wire (K-wire), which had been-used for fixation of proximal humerus fracture. A 74 year-old-woman visited the emergency room due to sudden onset of dyspnea. A chest x-ray and CT scan taken at the emergency room demonstrated 3 K-wires that had been applied to the proximal humerus fracture, 1 K-wire in the anterior chest wall, and mild pneumothorax of the right lung. An emergency removal of K-wire using thoracoscopy was performed and a chest tube was inserted for the treatment of pneumothorax during thoracic surgery. We removed residual 3 K-wires from the right proximal humerus and fixed right proximal humerus fracture by open reduction and internal fixation using a proximal humerus locking plate. We think that if a proximal humerus fracture is fixed using smooth K-wire, patients require close follow-up with the use of x-ray until the K-wire has been removed, in addition, it is very important to take steps to prevent K-wire migration.

Keyword

proximal humerus fracture; intrathoracic migration; Kirshner-wire

MeSH Terms

Chest Tubes
Dyspnea
Emergencies
Humans
Humerus
Lung
Pneumothorax
Thoracic Surgery
Thoracic Wall
Thoracoscopy
Thorax

Figure

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  Figure 1 Preoperative and immediate postoperative radiographs of right shoulder. Proximal humerus fracture is fixed by 4 K-wires.

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  Figure 2 (A) Chest radiograph shows K-wire at the thoracic cavity. (B) Chest computed tomography shows mild pneumothorax at right lung. White long arrow indicates the inferior tip of K-wire at anterior mediastinum penetrating anterior chest wall.

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  Figure 3 (A) Chest radiograph taken after removal of intrathoracic migrated K-wire and insertion of chest tube. (B) Radiograph of right shoulder shows removal of residual 3 K-wires and fracture fixation using a proximal humerus locking plate.

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