Aorto-Innominate Venous Fistula after Percutaneous Kirschner wire fixation of the Sternoclavivular Joint Anterior Dislocation - A case report -

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1 The Journal of the Korean Society of Fractures Vol11, No4, October, 1998 = Abstract = Aorto-Innominate Venous Fistula after Percutaneous Kirschner wire fixation of the Sternoclavivular Joint Anterior Dislocation - A case report - Choong-Gil Lee, MD, Jin-Woo Kwon, MD, Kyoung-Tae Sohn, MD, Seung-Ho Shin, MD, Jong-Cheon Park, MD Department of Orthopaedic Surgery, Pohang Sunrin Hospital Kirschner wire fixation in sternoclavicular dislocation poses a considerable risk of serious early or late complications We report a case of Kirschner wire penetration into the innominate vein and aorta, which caused aortovenous fistula and congestive heart failure : Sternoclavicular Joint, Percutaneous Kirschner wire fixation, Pin migration : 69-7 ( ) Tel : (0562) Fax : (0562)

2 954, continuous maschinary murmur, 4, - (Fig 1), 2 6 (grade IV), 2 8 / 19 / 23 m m H g 90/50mmHg, 82 /, 22 /, 36 5, 81 % 61 6,, 6 t h r i l l,, 10cm x 10cm Chest radiograph of 6 weeks after Kirschner wire removal operation shows increased pulmonary vascular marking and cardiomegaly Immediate postoperative radiograph shows fixation of the right sternoclavicular joint by two Kirschner wires The lower poles of the Kirschner wires penetrated the innominate vein and aorta

3 955, D e V e g a view, Hobbs view, Serendipity view, Tomograms, CT scan CT scan, 13, ),,,, 4 13 ) (Fig 2),,,,,,,,,, 2 6 Steinmann Pin,,, 2, 4, 6, 9, 10 ) 1984 Gerlach 4 ) 2 Brown 1 ) 10 3,, 2, 1,,, B a l l - a n d - S o c k e t Pate W i l h i t e 12 ), Clark 2 ) 30-35, 35, Smolle-Juettner 15 ) 45-50,,,,,,,,, 7, 5 m m,,,, 10, Leonard G i f f o r d 7 ), Liu 8 ),,,, Scott S e t h i 14 ), Ferrandez 3 ) H e i n i n g, Nordback

4 956 M a r k k u l a 10 ), Fatal Aortic Perforation and Cardiac Tamponade K r e m e n s G l a u s e r 6 ) Due to a Kirsciner Wire Migration From the Right G r a b s k i 5 ) Sternoclavicular Joint South med J, 67: , N o r r e l l 11 ) ) Ferrandes, L, Usabiaga, J, Ramos, L, Yubero, J and No, L : Migration of Kirschner Wires into S m o l l e - J u e t t n e r 15 ) Clark 2 ) the Mediastinum After Stabilization of Sternoclavicular Lesions : A Case report of Two Cases Chir Organi Mov, 76: , ) Gerlach, D, Wemhoner, SR, and Ogbuihi, S : On Two Cases of Fatal Heart Tamponade Due to Migration of Fracture Nails From the Sternoclavicular Joint Z Rechtmed, 93:53-60, ) Grabski, RS : Unusual Dislocation of a Fragment 10) of Kirschner Wire After Fixation of the Sternoclavicular Joint Wrad Lek, 40: , ) Kremens, Victor, and Glauser, Frank : Unusual 14 ) Sequela following Pinning of Medial Clavicular Fracture Am J Roentgenol, 76: , , 12 ), 7) Leonard, JW, and Gifford, RW : Migration of a 6, 7, 10 ) Kirschner Wire From the Clavicle into Pulmonary Artery Am J Cardiol, 16: , ) Liu, HP, Chang, CH,Lin, PJ, et al : Migration of Kirschner Wire for the Right Sternoclavicular Dislocations J Trauma, 8: , ) Nordback, I, and Markkula, H : Migration of - 1 Kirschner Pin From Clavicle Into Ascending Aorta, Acta Chir Scand, 151: , ) Norrell, H Jr, and Llewellyn RC : Migration of a threaded Steinmann Pin from an Acromioclavicular Joint into the Spinal Canal : A Case Report J Bone 1) Brown, JE : Anterior Sternoclavicular Dislocation : A Method of Repair Am J Orthop, 31: , ) Clark, RL, Milgram, JW, and Yawn, DH : Joint into the Main Pulmonary Artery : A Case Report Chang Gung Med J, 15:49-53, ) Nettles, JL, and Linscheid, R : Sternoclavicular joint Surg [Am], 47-A:1024-6, ) Pate, JW, and Wilhite, J : Migration of a Foreign Body From the Sternoclavicular Joint to the Heart : A Case Report Am Surg, 35: , ) Rockwood CA Jr and Green DP : Fractures in a d u l t s, 4th ed, Philadelphia, JB Lippincott Co, : , 1996

5 957 14) Sethi, GK, and Scott, SM : Subclavian Artery Laceration Due to Migration of a Hagie Pin S u r g e r y, 80: , ) Smolle-Juetter, FM, Hofer, PH, Pinter, H, Friehs, G, and Szyskowits, R : Intracardiac Malposioning of a Sternoclavicular Fixation Wire J Orthop Trauma, 6: , 1992