Migration intrarachidienne d’une broche de Kirschner après une cure de pseudarthrose de la clavicule. Cas clinique et revue de la littérature
| Autor: | Pierre Guigui, T Lenoir, D. Breitel, W. Mamane |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
Osteosynthesis business.industry medicine.medical_treatment Nonunion Laminectomy General Medicine Spinal cord medicine.disease Surgery medicine.anatomical_structure Clavicle medicine.artery medicine Orthopedics and Sports Medicine Intervertebral foramen business Spinal cord injury Subclavian artery |
| Zdroj: | Chirurgie de la Main. 28:367-369 |
| ISSN: | 1297-3203 |
| DOI: | 10.1016/j.main.2009.08.007 |
| Popis: | Kirschner wires (K-wires) are often used for osteosynthesis particularly in the upper limb. Postoperative K-wire migration through the tissues is a well-recognised and significant complication of surgery of the clavicle, the wire ending up in the lungs, the oesophagus, the aorta, or the subclavian artery. Localisation of a K-wire migration into the spinal cord is very rare. We report the case of a 34-year-old man with K-wire migration into the spinal cord through the intervertebral foramen of T2, two months after surgery for nonunion of a fracture of the lateral clavicle. Apart from acute respiratory failure related to a pneumothorax, the patient initially had no neurological deficit. It was decided to operate on him immediately. Two therapeutic options are possible: simple K-wire removal via a supraclavicular approach, or the same but with direct visual control in the spinal cord after laminectomy. A postoperative check with an MRI scan is desirable after two days. Even if mechanism of K-wire migration is not known, the means of prevention are, namely strict postoperative immobilization, K-wire removal as soon as bone healing is achieved, and bending the external tip of each implanted wire. |
| Databáze: | OpenAIRE |
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