MIGRATION OF THE KIRSHNER'S NEEDLE AFTER OSTEOSYNTHESIS OF THE CLAVICLE (CLINICAL CASE)

Author(s):  M.D. Romanov, Dr., Prof., National Research Ogarev Mordovia State University, Saransk, Russia, mdromanov@yandex.ru

V.I. Davydkin, candidate of Sciences, associate Professor, National Research Ogarev Mordovia State University, Saransk, Russia, v-dav@mail.ru

A.V. Pigachev, candidate of Sciences, associate Professor, National Research Ogarev Mordovia State University, Saransk, Russia, avpigachev@rambler.ru

E.M. Kireeva, candidate of Sciences, associate Professor, National Research Ogarev Mordovia State University, Saransk, Russia, emkireeva@yandex.ru

Issue:  Volume 42, № 1

Rubric:  Surgery

Annotation:  With a long stay of the Kirschner spokes in the area of accrete fracture of the clavicle, fragmentation and subsequent migration of the metal structure are possible due to sharp and high-amplitude movements in the shoulder girdle in violation of the regime of limiting loads on the fixation zone. When determining the fact of fragmentation and migration of the spokes in the vital structures of the chest, the unstable position of the fixator or its fragment shows their removal in an urgent order. With the development of acute pleural empyema, if the fragment does not pose an immediate threat to life, it must be removed after stopping the purulent-inflammatory process. It can be assumed that the reasons for the migration of the spokes fragment in this case were: excessive length of the metal structure, lack of reliable fixation of its distal end, untimely removal of the lock from the clavicle. The producing reasons were the fracture of the metal spoke caused by excessive volume of movements in the shoulder girdle and non-compliance with the recommendations of the traumatologist in the rehabilitation process. A possible reason for the development of pleural empyema in the remote period is the translocation of the spoke fragment into the pleural cavity with the development of hemothorax and subsequent infection of the latter.

Keywords:  migration of foreign bodies, a fragment of the Kirschner spokes, osteosynthesis of clavicle, empyema pleurae

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