Unusual Migration of a Kirschner Wire in a Patient With Osteogenesis Imperfecta: A Case Report Publisher Pubmed



Baghdadi T¹ ; Baghdadi S¹ ; Dastoureh K¹ ; Khan FMY¹ Show Affiliations
Source: Medicine (United States) Published:2018

Abstract

Rationale: Kirschner wires (K-wires) are the most commonly used implants in orthopedic surgery. Although complications are not uncommon, they are mostly benign in nature and easily managed. While migration of K-wires is a rare complication, fatal outcomes have been reported. A review of the literature showed that only 7 cases of wire migration in the hip and pelvic region have been reported. Only 2 occurred in the pediatric population. Although K-wires are routinely used in osteogenesis imperfecta (OI) patients, there has been no report of complications in this vulnerable patient population. Patient concerns: A 10-year-old girl with OI, presenting with gastrointestinal symptoms 1 year after operative fixation of a subtrochanteric femoral fracture. Pelvic x-ray showed a missing K-wire. Diagnosis: The patient was diagnosed with migration of a K-wire from the left femoral neck to the right retroperitoneal space. Interventions: The patient underwent surgery. During the operation, the migrated K-wire was extracted from just below the 12th rib on the right side. Outcomes: The patient had an uneventful rehabilitation, recovered completely, and was asymptomatic at 2-year follow-up. Lessons: There has been no prior report of migrated K-wires in the OI population. This is also the first report of a K-wire migrating from the femoral neck to the contralateral retroperitoneal region. Proper intraoperative bending of K-wires, timely removal of temporary K-wires, and considering K-wire migration in patients with retained hardware complaining of respiratory or gastrointestinal symptoms will prevent potentially life-threatening complications. Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. .