Migration of a Kirschner wire to the dorsolateral side of the foot following osteosynthesis of a patella fracture with tension band wiring: a case report

Abstract

BackgroundPatella fractures represent 1 % of all musculoskeletal system fractures. Fixation of patellar fractures using open reduction and tension band wiring is a commonly used and successful surgical fixation method.Case presentationA 28-year-old male patient from Turkey presented to our clinic with complaints of palpable foreign bodies under the skin on the dorsolateral side of his right foot. Except for the palpable and moving body of about 6 cm length under the skin in his foot, he had no functional complaints. On X-ray, a Kirschner wire was visible in front of the lateral malleolus on the dorsolateral side of his right foot. In addition, there was a cerclage wire from the tension band fixation of his patella in the ipsilateral knee. The Kirschner wire was removed surgically.ConclusionDespite the use of different fixation materials for the surgical treatment of patellar fractures, tension band wiring is still a commonly used technique. We recommend that after fixation of a patellar fracture using the tension band wiring technique, the ends of the Kirschner wires be bent and the wires then removed in the early phase after patellar union to prevent Kirschner wire migration.

A rare complication of tension band fixation of olecranon osteotomy: Distal migration of K-wire

“…Only one case was reported distal migration of the K-wire from the patella to the ankle. [ 11 ] In our case, K-wire migrated from the elbow to the forearm, which has not been reported previously. During our literature research, there was no certain data about the cause of K-wire migration.…”

“…During our literature research, there was no certain data about the cause of K-wire migration. [ 1 - 7 , 11 - 13 ] Muscle contraction and gravity may be a factor for distal migration due to K-wire protrusion from the volar cortex of the ulna. Additionally, the K-wire migration in our case may be due to the shortness of the bent part of the K-wire (Figure 3b).…”

Treatment of displaced fractures of the patella: Tension band wiring technique with the one-end or both-ends K-wire bending fixation method

“…19,20 A broken wire has also been reported to have migrated from the patella into the proximal tibia and the dorsolateral side of the foot. 21,22 Broken wires from the patella, besides lying in the soft tissue envelope around the knee joint, have even been reported to have migrated to the heart. 1 Due to the surface of the K-wire having no threaded sectors to fix to the bone, and the K-wire in the modified AO tension band technique being under traction by the quadriceps in the knee joint, loosening of K-wires is the main complication of TBW fixation of patella fractures.…”

Locking Compression Plate Distal Ulna Hook Plates as Alternative Fixation for Avulsion Fractures of the Tip of the Lateral Malleolus

“…In addition, any screw with threads causes further complications in patients whose distal bula growth plate has not been closed [11]. A Kirschner wire tension band is another alternative xation method, but complications such as skin and soft tissue irritation, loosening and hardware breakage are likely to occur [15]. Moreover, these fracture fragments are often not large enough to be suitable for a distal bula anatomical LCP.…”