Yasmin Youssef1, Peter Melcher2, Matthias Steinert3, Isabella Metelmann3, Pierre Hepp2, Jan Theopold2. 1. Klinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum, Bereich für arthroskopische und spezielle Gelenkchirurgie/Sportverletzungen Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland. yasmin.youssef@medizin.uni-leipzig.de. 2. Klinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum, Bereich für arthroskopische und spezielle Gelenkchirurgie/Sportverletzungen Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland. 3. Klinik für Viszeral‑, Thorax‑, Transplantations- und Gefäßchirurgie, Bereich Thoraxchirurgie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland.
Abstract
BACKGROUND: Lateral clavicle fractures can be treated both conservatively and surgically depending on the fracture classification. Different surgical techniques have been described for the operative treatment. The selection of the appropriate technique is decisive for the functional outcome and healing process without complications. CASE: We report on a patient with a secondary dislocation of two Kirschner wires after Kirschner wire osteosynthesis. The secondary dislocation caused one of the wires to migrate into the mediastinum and pulmonary tissue, directly under the aortic arch. To prevent further migration with potential damage to surrounding structures, a uniportal video-assisted thoracoscopy was performed to retrieve the wire. CONCLUSION: The treatment of lateral clavicle fractures should be performed with bent Kirschner wires as they can otherwise lead to severe complications including the occurrence of pseudarthrosis or secondary migration of the material. Safe and stable surgical techniques (plate osteosynthesis, hybrid treatment) should be preferred if they are available.
BACKGROUND: Lateral clavicle fractures can be treated both conservatively and surgically depending on the fracture classification. Different surgical techniques have been described for the operative treatment. The selection of the appropriate technique is decisive for the functional outcome and healing process without complications. CASE: We report on a patient with a secondary dislocation of two Kirschner wires after Kirschner wire osteosynthesis. The secondary dislocation caused one of the wires to migrate into the mediastinum and pulmonary tissue, directly under the aortic arch. To prevent further migration with potential damage to surrounding structures, a uniportal video-assisted thoracoscopy was performed to retrieve the wire. CONCLUSION: The treatment of lateral clavicle fractures should be performed with bent Kirschner wires as they can otherwise lead to severe complications including the occurrence of pseudarthrosis or secondary migration of the material. Safe and stable surgical techniques (plate osteosynthesis, hybrid treatment) should be preferred if they are available.