Spinal cord penetration of a migrated broken Kirschner wire from Acromio-clavicular joint fixation: a rare case report and literature review.

Abstract

PURPOSE: Kirschner wires (K-wires) are commonly used for fixation of acromio-clavicular joint injuries. Although migration of broken K-wires has been described, migration of a broken K-wire into the spinal canal with spinal cord impalement is exceedingly rare. METHODS: We report the case of a 30-year-old man who underwent tension band wiring with K-wires for a displaced distal clavicle fracture. Fourteen months later, he presented with neck pain and headache without neurological deficit. Imaging revealed breakage of one of the K-wires with migration through the C7–T1 neural foramen into the spinal canal, impaling directly through the spinal cord. RESULTS: Under general anaesthesia, the wire was successfully retrieved using a right supraclavicular brachial plexus approach. Though CSF leak was encountered, the patient recovered without neurological sequelae. CONCLUSION: This case highlights the potentially catastrophic complications of retained K-wires around the shoulder girdle and underscores the importance of regular follow-up and timely implant removal. Even in cases of spinal canal migration, careful surgical planning can result in safe extraction with favourable outcomes.