Abstract
In orthopaedic patients, peripheral intravenous (IV) cannulation is a common procedure for various clinical purposes. This patient was introduced with a 17G cannula in the basilic vein of the dorsal venous arch of the left hand prior to knee replacement surgery. Post knee surgery patients use walking aids for mobilization. Cannula which has been placed at the dorsum of the hand has a potential to bend at the neck of the cannula when the wrist bend while holding the walking aid. Repeated bending can result in fatigue fracture of the cannula neck. In this patient at the time of cannula removal, it was noted the catheter part is broken and proximal migration. Ultrasound guided localization was done and removed with a venotomy under local anesthesia. It is advisable to place peripheral venous cannulas well away from the wrist joint, which will prevent catheter bending and fracture. This is a very important point to consider when placing cannulas in orthopaedic patients who undergo surgical procedures.
Highlights
IntroductionPeripheral intravenous (IV) cannulation is the easiest and most common procedure used to obtain intravenous access
In orthopaedic patients, peripheral intravenous (IV) cannulation is the easiest and most common procedure used to obtain intravenous access.Peripheral intravenous cannulation is essential for the delivery of intravenous medications, fluids and other intravascular replacements
60.0% of all patients treated by a healthcare system will have an IV cannula inserted for some purpose [1]
Summary
Peripheral intravenous (IV) cannulation is the easiest and most common procedure used to obtain intravenous access. Intravenous fracture of a cannula is rare, but it can occur and may result in serious consequences, such as distal embolization. Most cannulas are placed in the dorsum of the hand or wrist since the dorsal venous arch is the most comfortable place to site a cannula. Cannula fragments can be distally embolized and result in hazardous consequences In this case report, we discuss a case of an intravenous fracture of an IV cannula that was placed at the basilic vein of the dorsal venous arch of the hand. The patient was mobilized with a walker, and during the mobilization procedure, the cannula was bent and fractured. The cannula acted as an intravascular foreign body and migrated proximally
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