A 55-year-old male patient was admitted to the emergency service with dyspnea, stabbing chest pain. The symptom had first appeared 3 days earlier. The patient’s medical history showed that he had undergone a fixation operation using K-wire and plate for treatment of the right sternoclavicular joint dislocation about 5 months prior(Fig. A, B). His vital signs were stable in physical examination. Chest radiograph showed a broken K-wire around sternoclavicular joint and a linear metallic foreign body in thorax (Fig. C). Chest computerized tomography revealed the metallic foreign body in the heart (Fig. D–F). There was no evidence of cardiac tamponade or segmental wall motion abnormality in preoperative transthoracic echocardiography. Removal of the wire was recommended and the patient underwent cardiac surgery under general anesthesia via median sternotomy without cardiopulmonary bypass. After pericardiotomy, there was about 50 ml old hematocele in pericardium. The broken K-wire was located between the aorta and the pulmonary artery, behind the right auricle (Fig. ). Because the wire had a linear shape, it was removed easily. There was an 8 millimeter diameter hematoma caused by K-wire in the anterior wall of the ascending aorta. After clearing the hematoma, the local bleeding tissue was sutured. There was no injury to the heart muscle. The pericardium was closed in standard fashion. There were not any cardiac conduction and rhythm disturbances intra-operatively. Then the K-wire retained around the sternoclavicular joint was removed. The entire intra-operative blood loss was about 100 ml. Follow-up chest radiograph was performed on the third postoperative day (Fig. G, H). The patient recovered without any complications and was discharged on the 7th postoperative day. In follow-up 1 year post-surgery, the patient had no particular symptoms such as cough, chest pain and irregular heartbeat.
A 28-year-old male patient from Turkey presented to our clinic with complaints of palpable foreign bodies under the skin in the dorsolateral side of his right foot (Fig. ). Except for the palpable and moving body of about 6 cm length under the skin in his foot, he had no functional complaints. An X-ray demonstrated the presence of a K-wire of about 6 cm length in front of the lateral malleolus in the dorsolateral side of his foot (Fig. ). There was a cerclage wire from the tension band fixation of his patella in the ipsilateral knee (Fig. ). There was no diagnostic challenge. Our patient explained that he was operated on by another orthopedic surgeon in the same hospital after a patellar fracture in 2007 and he had not attended regular checks. He also reported that a wire similar to the one in the X-ray had protruded through his skin in 2009 and he had removed the wire by pulling it out. This statement explained why the K-wire was not in place.\nOn physical examination, our patient showed no restriction in his knee movement. Routine blood test results showed no abnormalities. Palpation of the K-wire showed that the wire was mobile under his skin (Fig. ). Our patient reported that, after removing the first wire, he had not felt any serious discomfort during the migration of the other wire over a period of 5 years.\nOur patient was taken to the operating room. After staining, a 3-mm skin incision was made that coincided with the proximal end of the K-wire, and the K-wire was pulled out with the help of clamp (Fig. ). Our patient was discharged on the same day. The cerclage wire in his patella was not removed to avoid creating complications and because of our patient’s unwillingness to have it removed.