Skip to main content
Top
Published in: Journal of Medical Case Reports 1/2016

Open Access 01-12-2016 | Case report

Intraspinal migration of a Kirschner wire as a late complication of acromioclavicular joint repair: a case report

Authors: Bartosz Mankowski, Tadeusz Polchlopek, Marcin Strojny, Pawel Grala, Krzysztof Slowinski

Published in: Journal of Medical Case Reports | Issue 1/2016

Login to get access

Abstract

Background

Penetrating neck trauma involving foreign bodies is a rare event in European countries. Due to its relatively high mortality rate, the correct management strategy must be initiated from the beginning to prevent fatal complications. In the medical literature, there are only a few cases describing foreign bodies penetrating the cervical spine. Because of its rareness, many trauma centers lack the proper routine to adequately manage such injuries.

Case presentation

This case report describes a 34-year-old white man of Central European descent with Kirschner wire migration and perforation of his vertebral foramen. He underwent acromioclavicular joint repair surgery 7 years ago, presented with a painful sensation around the area of his left clavicle and left side of his neck after a motorcycle accident. No neurological deficit was detected.

Conclusions

In such cases, a thorough radiological evaluation of the spinal cord and the surrounding vasculature is mandatory for a complete understanding of the extent of the injury and determining the proper surgical management. In cases of vertebral artery trauma both an endovascular and an open approach can be contemplated.
Literature
1.
go back to reference Van Waes OJ, Cheriex KC, Navsaria PH, van Riet PA, Nicol AJ, Vermeulen J. Management of penetrating neck injuries. Br J Surg. 2012;99:149–54.CrossRefPubMed Van Waes OJ, Cheriex KC, Navsaria PH, van Riet PA, Nicol AJ, Vermeulen J. Management of penetrating neck injuries. Br J Surg. 2012;99:149–54.CrossRefPubMed
2.
go back to reference Munera F, Cohn S, Rivas LA. Penetrating injuries of the neck: use of helical computed tomographic angiography. J Trauma. 2005;58:413–8.CrossRefPubMed Munera F, Cohn S, Rivas LA. Penetrating injuries of the neck: use of helical computed tomographic angiography. J Trauma. 2005;58:413–8.CrossRefPubMed
3.
go back to reference Tallon JM, Ahmed JM, Sealy B. Airway management in penetrating neck trauma at a Canadian tertiary trauma centre. CJEM. 2007;9:101–4.CrossRefPubMed Tallon JM, Ahmed JM, Sealy B. Airway management in penetrating neck trauma at a Canadian tertiary trauma centre. CJEM. 2007;9:101–4.CrossRefPubMed
4.
go back to reference Wang Z, Liu Y, Qu Z, Leng J, Fu C, Liu G. Penetrating injury of the spinal cord treated surgically. Orthopedics. 2012;35:1136–40.CrossRef Wang Z, Liu Y, Qu Z, Leng J, Fu C, Liu G. Penetrating injury of the spinal cord treated surgically. Orthopedics. 2012;35:1136–40.CrossRef
5.
go back to reference Fransen P, Bourgeois S, Rommens J. Kirschner wire migration causing spinal cord injury one year after internal fixation of a clavicle fracture. Acta Orthop Belg. 2007;73:390–2.PubMed Fransen P, Bourgeois S, Rommens J. Kirschner wire migration causing spinal cord injury one year after internal fixation of a clavicle fracture. Acta Orthop Belg. 2007;73:390–2.PubMed
6.
go back to reference Mwipatayi BP, Jeffery P, Beningfield SJ, Motale P, Tunnicliffe J, Navsaria PH. Management of extra-cranial vertebral artery injuries. Eur J Vasc Endovasc Surg. 2004;27:157–62.CrossRefPubMed Mwipatayi BP, Jeffery P, Beningfield SJ, Motale P, Tunnicliffe J, Navsaria PH. Management of extra-cranial vertebral artery injuries. Eur J Vasc Endovasc Surg. 2004;27:157–62.CrossRefPubMed
7.
8.
go back to reference Eastman AL, Chason DP, Perez CL, McAnulty AL, Minei JP. Computed tomographic angiography for the diagnosis of blunt cervical vascular injury: is it ready for primetime? J Trauma. 2006;60:925–9.CrossRefPubMed Eastman AL, Chason DP, Perez CL, McAnulty AL, Minei JP. Computed tomographic angiography for the diagnosis of blunt cervical vascular injury: is it ready for primetime? J Trauma. 2006;60:925–9.CrossRefPubMed
9.
go back to reference Fassett DR, Dailey AT, Vaccaro AR. Vertebral artery injuries associated with cervical spine injuries: a review of the literature. J Spinal Disord Tech. 2008;21:252–8.CrossRefPubMed Fassett DR, Dailey AT, Vaccaro AR. Vertebral artery injuries associated with cervical spine injuries: a review of the literature. J Spinal Disord Tech. 2008;21:252–8.CrossRefPubMed
11.
go back to reference Biffl WL, Moore EE, Elliott JP, Ray C, Offner PJ, Franciose RJ, et al. The devastating potential of blunt vertebral arterial injuries. Ann Surg. 2000;231:672–81.CrossRefPubMedPubMedCentral Biffl WL, Moore EE, Elliott JP, Ray C, Offner PJ, Franciose RJ, et al. The devastating potential of blunt vertebral arterial injuries. Ann Surg. 2000;231:672–81.CrossRefPubMedPubMedCentral
12.
go back to reference Miller PR, Fabian TC, Bee TK, Timmons S, Chamsuddin A, Finkle R, et al. Blunt cerebrovascular injuries: diagnosis and treatment. J Trauma. 2001;51:279–85 (discussion 285–6).CrossRefPubMed Miller PR, Fabian TC, Bee TK, Timmons S, Chamsuddin A, Finkle R, et al. Blunt cerebrovascular injuries: diagnosis and treatment. J Trauma. 2001;51:279–85 (discussion 285–6).CrossRefPubMed
13.
go back to reference Wada S, Noguchi T, Hashimoto T, Uchida Y, Kawahara K. Successful treatment of a patient withpenetrating injury of the esophagus and brachiocephalic artery due to migration of Kirschner wires. Annals of Thoracic Cardiovascular Surgery. 2005;11(5):313–5. Wada S, Noguchi T, Hashimoto T, Uchida Y, Kawahara K. Successful treatment of a patient withpenetrating injury of the esophagus and brachiocephalic artery due to migration of Kirschner wires. Annals of Thoracic Cardiovascular Surgery. 2005;11(5):313–5.
14.
go back to reference Ulm AJ, Quiroga M, Russo A, Russo VM, Graziano F, Velasquez A, et al. Normal anatomical variations of the V3 segment of the vertebral artery: surgical implications. J Neurosurg Spine. 2010;13:451–60.CrossRefPubMed Ulm AJ, Quiroga M, Russo A, Russo VM, Graziano F, Velasquez A, et al. Normal anatomical variations of the V3 segment of the vertebral artery: surgical implications. J Neurosurg Spine. 2010;13:451–60.CrossRefPubMed
15.
go back to reference Hong JT, Park D, Lee MJ, Kim SW, An HS. Anatomical variations of the vertebral artery segment in the lower cervical spine. Spine. 2008;33:2422–6.CrossRefPubMed Hong JT, Park D, Lee MJ, Kim SW, An HS. Anatomical variations of the vertebral artery segment in the lower cervical spine. Spine. 2008;33:2422–6.CrossRefPubMed
16.
go back to reference Bruneau M et al. Anatomical variations of the V2 segment of the vertebral artery. Oper Neurosurg. 2006;59:20–3. Bruneau M et al. Anatomical variations of the V2 segment of the vertebral artery. Oper Neurosurg. 2006;59:20–3.
17.
18.
go back to reference Pham MH, Rahme RJ, Arnaout O, Hurley MC, Bernstein RA, Batjer HH, et al. Endovascular stenting of extracranial carotid and vertebral artery dissections: a systematic review of the literature. Neurosurg. 2011;68:856–66.CrossRef Pham MH, Rahme RJ, Arnaout O, Hurley MC, Bernstein RA, Batjer HH, et al. Endovascular stenting of extracranial carotid and vertebral artery dissections: a systematic review of the literature. Neurosurg. 2011;68:856–66.CrossRef
19.
go back to reference Herrera DA, Vargas SA, Dublin AB. Endovascular treatment of traumatic injuries of the vertebral artery. Am J Neuroradiol. 2008;29:1585–9.CrossRefPubMed Herrera DA, Vargas SA, Dublin AB. Endovascular treatment of traumatic injuries of the vertebral artery. Am J Neuroradiol. 2008;29:1585–9.CrossRefPubMed
Metadata
Title
Intraspinal migration of a Kirschner wire as a late complication of acromioclavicular joint repair: a case report
Authors
Bartosz Mankowski
Tadeusz Polchlopek
Marcin Strojny
Pawel Grala
Krzysztof Slowinski
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2016
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-016-0844-4

Other articles of this Issue 1/2016

Journal of Medical Case Reports 1/2016 Go to the issue