Migração do fio de Kirschner após o tratamento da luxação acromioclavicular para o ombro contralateral: relato de caso

Abstract

The use of metal wires, called Kirschner wires, is a simple and effective fixation method for the correction of shoulder fractures and dislocations in orthopedic surgery. Wire migration during postoperative follow‐up is a possible complication of the procedure. The authors present the case of a male patient of 48 years, business administrator, who suffered a fall on the same level with trauma in the right shoulder, during a football match. The patient was treated at a referral hospital in orthopedics, and was diagnosed with a grade V acromioclavicular dislocation. Four days after the trauma, the surgical treatment of the acromion‐clavicular dislocation was performed; the technique consisted of ligatures with anchor wires, transfer of the coraco‐acromial ligament, and fixation with Kirshner wires from the acromion to the clavicle. On the follow‐up consultation, twelve days after the surgical procedure, a migration of the Kirschner wire to the acromion edge was identified. The patient was oriented to undergo another surgery to remove the Kirshner wire, due to the possibility of migration; nonetheless, he refused surgery. After nine months of surgical treatment, the patient complained of pain on the left shoulder (contralateral side), difficulty mobilizing the shoulder, ecchymosis, and protrusion. Bilateral radiographs were made, which demonstrated that the Kirschner wire, originally from the right shoulder, was on the left side. The patient then underwent a successful surgery to remove the implant.