Migration of K-wire into the cavum pleura after the reduction of acromioclavicular dislocation, a case report and review of literature

INTRODUCTION: The use of K-wire (Kirschner wire) in acromioclavicular dislocation was the first trans-articular fixation technique to be described. PRESENTATION OF CASE: A 40-years-old man was presented to the emergency room (ER) with shortness of breath. He had a history of acromioclavicular dislocation two years ago, which had been treated using two K-wires and tension band wiring. The plain x-ray revealed left side pneumothorax with K-wire migrated into the left hemithorax. CT scan showed that K-wire migrated into the posterior cavum pleura. A chest tube was then inserted, and the removal of K-wire was performed using thoracoscopic assisted surgery followed by the removal of the remaining K-wire in the left shoulder. Three days post-surgery, the chest tube was removed, and the patient was discharged from the hospital. DISCUSSION: This technique is easy and cheap, but it can cause lethal complications. K-wire can migrate into the area of vital organs, including the liver, heart, neck lung subclavian artery, and aorta. CONCLUSION: K-Wire should be used cautiously for treating upper extremity injury, especially acromioclavicular dislocation, due to its lethal complications. This method is outdated and should be restricted as much as possible.