Migration of Kirschner's pin from the right sternoclavicular joint resulting in perforation of the pulmonary artery main trunk.

The spontaneous migration, in a 62-year-old patient, of a broken Kirschner's pin from the right sternoclavicular joint to the anterior mediastinum, with perforation of the pericardium and puncture of the main trunk of the pulmonary artery resulting in cardiac tamponade, is described. A review of the literature stresses the high risk of migration when pins or wires are used for internal fixation of the shoulder girdle, resulting sometimes in life-threatening situations and the need for major thoracic interventions. It seems mandatory to remove all foreign material after consolidation, certainly when pins or wires are broken or when there is evidence of local bone resorption, as the broken parts may migrate. The legal implications, when adequate and regular follow-up has been neglected, are described.