A rare case of penetrating lung and cardiac injury due to late migration of  multiple Kirschner-wire after shoulder fracture fixation

Aims The aim of this study was to examine trends in the management of fractures of the distal radius in Ireland over a ten-year period, and to determine if there were any changes in response to the English Distal Radius Acute Fracture Fixation Trial (DRAFFT). Patients and Methods Data was grouped into annual intervals from 2008 to 2017. All adult inpatient episodes that involved emergency surgery for fractures of the distal radius were included Results In 2008 Kirschner-wire (K-wire) fixation accounted for 59% of operations for fractures of the distal radius, and plate fixation for 21%. In 2017, the rate of K-wire fixation had fallen to 30%, and the proportion of patients who underwent plate fixation had risen to 62%. Conclusion There is an increasing trend towards open reduction and internal fixation for fractures of the distal radius in Ireland. This has been accompanied by a decrease in popularity for K-wire fixation. DRAFFT did not appear to influence trends in the management of fractures of the distal radius in Ireland. Cite this article: Bone Joint J 2019;101-B:1550–1556

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Intraspinal migration of a Kirschner wire 3 months after clavicular fracture fixation

Neurosurgical Review ◽

10.1007/s101430100186 ◽

2002 ◽

Vol 25 (1-2) ◽

pp. 110-112 ◽

Cited By ~ 50

Author(s):

Jens P. Regel ◽

Josef Pospiech ◽

Thomas A. Aalders ◽

Steffen Ruchholtz

Keyword(s):

Fracture Fixation ◽

Kirschner Wire ◽

Clavicular Fracture

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Trans-mediastinal Kirschner wire migration treated by video-assisted thoracoscopy

Asian Cardiovascular and Thoracic Annals ◽

10.1177/0218492318785262 ◽

2018 ◽

Vol 26 (6) ◽

pp. 482-484

Author(s):

Alberto Cabañero ◽

Patricia Ovejero ◽

Luis Gorospe ◽

Percy Serranol ◽

Gemma Muñoz ◽

...

Keyword(s):

Thoracic Surgery ◽

Orthopedic Surgery ◽

Rare Case ◽

Clavicle Fracture ◽

Kirschner Wire ◽

Video Assisted Thoracic Surgery ◽

Video Assisted ◽

Osteosynthesis Material

The use of osteosynthesis material in shoulder and clavicle surgery is common in orthopedic surgery. Although migration is rare, it is widely documented and can lead to serious complications and even death. We present a rare case of trans-mediastinal migration of a Kirschner needle used to fix a clavicle fracture, which fortunately did not injure the mediastinal structures and was resolved favorably by a video-assisted thoracic surgery approach.

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Fracture of pubic rami during hip fracture fixation: a rare case of traction table–related injury

BMJ Case Reports ◽

10.1136/bcr-2021-246581 ◽

2022 ◽

Vol 15 (1) ◽

pp. e246581

Author(s):

Austin Gomindes ◽

Mohammedabbas Remtulla ◽

Julian Cooper ◽

Anastasios P Nikolaides

Keyword(s):

Risk Factors ◽

Hip Fracture ◽

Intramedullary Nail ◽

Fracture Fixation ◽

Closed Reduction ◽

Rare Case ◽

Pubic Rami ◽

Reduction Techniques ◽

Morbidity Risk

We present a case of an elderly and comorbid patient who was scheduled to undergo a hip fracture fixation using an intramedullary nail. Unfortunately, this was delayed by 3 weeks as the patient was unfit to undergo this procedure. She was placed onto the traction table and intraoperatively sustained a superior and inferior pubic rami fracture while attempting reduction on the traction table. Closed-reduction techniques using traction tables and perineal posts are not without morbidity. Risk factors such as osteoporosis and delayed-fixation should be accounted for when managing this complex and often frail group of patients.

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Chronic Heart Perforation With 13.5 cm Long Kirschner Wire Without Pericardial Tamponade: An Unusual Sequelae After Shoulder Fracture

The Annals of Thoracic Surgery ◽

10.1016/j.athoracsur.2005.06.061 ◽

2006 ◽

Vol 81 (5) ◽

pp. 1895-1897 ◽

Cited By ~ 14

Author(s):

Igor Medved ◽

Ognjen Simic ◽

Marina Bralic ◽

Valter Stemberga ◽

Miljenko Kovacevic ◽

...

Keyword(s):

Kirschner Wire ◽

Pericardial Tamponade ◽

Shoulder Fracture

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Perioperative support of a patient with fat embolism syndrome with extracorporeal membraneoxygenation

BMJ Case Reports ◽

10.1136/bcr-2018-227747 ◽

2019 ◽

Vol 12 (5) ◽

pp. e227747 ◽

Cited By ~ 3

Author(s):

Ivor Popovich ◽

Vikrant Singh ◽

Bevan Vickery

Keyword(s):

Fracture Fixation ◽

Rare Case ◽

Distress Syndrome ◽

Multiorgan Failure ◽

Fat Embolism ◽

Extracorporeal Circuit ◽

Fat Embolism Syndrome ◽

Embolism Syndrome ◽

Venovenous Extracorporeal Membrane Oxygenation ◽

Vv Ecmo

Fat embolism syndrome (FES) is a serious complication of trauma that can result in multiorgan failure, including the acute respiratory distress syndrome. Occasionally, the severity of respiratory failure associated with FES warrants support with venovenous extracorporeal membrane oxygenation (VV-ECMO), a therapy with widespread use but inconclusive evidence. Early definitive fracture fixation is the mainstay of preventing further fat embolism and ongoing organ dysfunction, but poses significant risks to the maintenance of the extracorporeal circuit. We describe a rare case of a patient who required VV-ECMO for respiratory support prior to fracture fixation. The risks of intraoperative fat embolisation causing sudden circuit failure were managed by having a spare circuit available outside the operating room with readiness for an emergency circuit change. Postoperative fat deposition in the oxygenator was managed by a circuit change. Our case is the first to describe preoperative initiation of VV-ECMO for FES and highlights why this therapy should not delay definitive fracture fixation and how it can be safely managed in this setting.

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High Rates of Occult Infection After Shoulder Fracture Fixation: Considerations for Conversion Shoulder Arthroplasty

HSS Journal ® ◽

10.1007/s11420-015-9450-z ◽

2015 ◽

Vol 11 (3) ◽

pp. 198-203 ◽

Cited By ~ 7

Author(s):

Till O. Klatte ◽

Reza Sabihi ◽

Daniel Guenther ◽

Atul F. Kamath ◽

Johannes M. Rueger ◽

...

Keyword(s):

Fracture Fixation ◽

Shoulder Arthroplasty ◽

Occult Infection ◽

Shoulder Fracture

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Traumatic Cardiac Injury: Ventricular Perforation Caught on CT

Case Reports in Radiology ◽

10.1155/2016/9696107 ◽

2016 ◽

Vol 2016 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Behrad Golshani ◽

Paul Dong ◽

Scott Evans

Keyword(s):

Computed Tomography ◽

Right Ventricle ◽

Rare Case ◽

Cardiac Injury ◽

Clinical Severity ◽

Imaging Diagnosis ◽

Operative Repair ◽

Trauma Service ◽

Myocardial Rupture ◽

The Right

Myocardial rupture is a rare imaging diagnosis given its clinical severity and high mortality. Early findings should be promptly communicated to the trauma service to ensure immediate intervention. We present a rare case of blowout perforation of the right ventricle which was prospectively diagnosed on computed tomography (CT) leading to emergent operative repair. The patient subsequently survived and was discharged after a lengthy hospital course.

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The Role of Biofilm Formation in Percutaneous Kirschner-Wire Fixation of Radial Fractures

Journal of Hand Surgery (European Volume) ◽

10.1054/jhsb.2002.0756 ◽

2002 ◽

Vol 27 (4) ◽

pp. 365-368 ◽

Cited By ~ 8

Author(s):

D. G. HARGREAVES ◽

A. PAJKOS ◽

A. K. DEVA ◽

K. VICKERY ◽

S. L. FILAN ◽

...

Keyword(s):

Electron Microscopy ◽

Scanning Electron Microscopy ◽

Fracture Fixation ◽

Biofilm Formation ◽

Bacterial Colonization ◽

Kirschner Wire ◽

Bacterial Biofilm ◽

Broth Culture ◽

Bacterial Counts ◽

Scanning Electron

This study examines the formation of bacterial biofilms on percutaneous wires used for fracture fixation. Twelve control (clinically uninfected) wires and ten infected wires were collected and examined using broth culture and scanning electron microscopy. Three of the 12 control wires grew Staphylococcus spp. with very low bacterial counts in their percutaneous portions. In the clinically infected wires, six wires in four subjects had positive cultures in their percutaneous portions and four of these also had positive cultures in their deep portions with much higher bacterial counts than the controls. In two patients (four wires) treated with antibiotics, cultures were negative except for the percutaneous portion of one wire. Scanning electron microscopy did not reveal bacterial biofilm formation, but biological deposit without bacteria was noted on most wires. During the 6 weeks of fracture fixation, some bacterial colonization of wires occurred, but bacteria did not form biofilms which may increase bacterial resistance to systemic antibiotics, cause implant loosening and act as a source of late infection.

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Headless Screw Fixation of Metacarpal Neck Fractures: A Mechanical Comparative Analysis

Hand ◽

10.1177/1558944717731859 ◽

2017 ◽

Vol 14 (2) ◽

pp. 187-192 ◽

Cited By ~ 4

Author(s):

Christopher M. Jones ◽

Eric M. Padegimas ◽

Nicole Weikert ◽

Samuel Greulich ◽

Asif M. Ilyas ◽

...

Keyword(s):

Cyclic Loading ◽

Fracture Fixation ◽

Kirschner Wire ◽

Testing Machine ◽

Fourth Generation ◽

Mechanical Fracture ◽

Fixation Methods ◽

Load To Failure ◽

Neck Fracture ◽

Material Testing Machine

Background: The purpose of this study was to compare the mechanical properties of metacarpal neck fracture fixation by headless compression screw (HCS) with that of Kirschner wire (KW) cross-pinning and locking plate (LP) fixation. Methods: A metacarpal neck fracture was created in 30 fourth-generation composite Sawbones metacarpal models. A volar-based wedge was removed using a custom jig to simulate a typical apex dorsal fracture, unstable in flexion. The models were divided into 3 equal groups based on the method of fixation: retrograde cross-pinning with two 1.2-mm KWs, 2.0-mm dorsal T-plate with six 2.0-mm locking screws (LP), and a 3.0-mm retrograde HCS. Models were fixed at the proximal end, mounted in a material testing machine, and loaded through a cable tensioned over the metacarpal head, simulating grip loading. Cyclic loading from 0 to 40 N was performed, followed by loading to failure. Load, displacement, and failure mode were recorded. Results: Stiffness of the HCS (7.3 ± 0.7 N/m) was significantly greater than the KW (5.8 ± 0.5 N/m) but significantly less than the LP (9.5 ± 1.9 N/m). With cyclic loading to 40 N, the LP exhibited significantly less displacement (0.2 ± 1.3 mm) compared with the HCS (2.5 ± 2.3 mm) and KW (2.8 ± 1.0 mm). Load to failure for the HCS (215.5 ±3 9.0 N) was lower than that of the KW (279.7 ± 100.3 N) and of the LP (267.9 ± 44.1 N), but these differences were not statistically significant. Conclusions: The HCS provided mechanical fracture fixation properties comparable with KW fixation. The LP construct allowed significantly less displacement and had the highest strength of the 3 fixation methods.

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