Intraspinal migration of a Kirschner wire 3 months after clavicular fracture fixation.

The authors describe a patient who had Kirschner (K-) wire osteosynthesis of a right lateral clavicular fracture and developed a tetraparesis after 3 months. Plain X-ray and CT scan showed an intraspinal migration of one K-wire through the intervertebral foramen of C5/6. The K-wire was pulled out through an opening of the wound over the right clavicle. No CSF fistula was seen. The patient recovered without any postoperative neurological deficit. Patients with K-wire osteosynthesis should be informed about the risk of dislocation and wandering and should regularly be seen in the outpatient clinic. Regular X-rays should be performed. The K-wires must be sufficiently bent at the distal end to prevent wandering into the proximal direction. The K-wires should be removed soon after 6 weeks and, in cases of dislocation and migration, as early as possible.