Abstract The use of percutaneous fixation wires for orthopedic injuries may be associated with the complication of wire migration. Here, we report on the migration of three proximal humerus wires five weeks after insertion; one of which we believe may be the longest distance traveled for a percutaneous wire into the pelvis. The patient is a 67-year-old female who underwent percutaneous pinning with four Kirshner wires for a left proximal humerus fracture. At a five-week follow up appointment she underwent removal of one of these wires secondary to ongoing pain. Radiographs showed the other three wires were no longer at the site of repair. Subsequent spiral CT scans of the chest, abdomen and pelvis showed migration of the remaining three wires into the mediastinum, pelvis, and left posterorlateral back. The intrathoracic wire traversed the subclavicular tissue, anterior to the left common carotid artery and terminated anterior to the trachea, abutting the brachiocephalic artery. The pelvic wire traversed the preperitoneal space to abut the left external iliac vein and sigmoid colon. All wires were successfully removed surgically through small incisions with the aid of ultrasound and fluoroscopy and without complication. The patient made an uneventful recovery. Proposed theories for wire migration include bone resorption, extremity motion, muscular contraction, respiratory motion and negative intrathoracic pressure. Regardless of cause, caution must be taken to avoid wire migration and vigilant follow up with radiographs can help reduce morbidity associated with this complication.
Keywords: surgery; Kirshner wire; humeral fixation; k-wire; wire migration