A 34-year-old Taiwanese man presented to our emergency department with a 3-day history of coughing and chest tightness. He had a history of essential hypertension and congestive heart failure followed up at our cardiovascular department and under medication control. He was an express delivery worker with right hand dominance.\nA chest radiograph on November 16, 2018, revealed metallic internal fixation pins and wire over his right clavicle, and an unidentified object of metallic density at the left side of his upper neck. A further cervical spine radiograph was arranged, which revealed a foreign body of metallic density crossing over the C2–C4 level on the left side of his neck (Fig. ) that indicated a loosened K-wire. He recalled that he had suffered from a right clavicle fracture which was operated on for wire fixation approximately 15 years ago, but had lost follow-up since then. Palpation of his neck revealed no palpable foreign body. His oral cavity was clear, and findings on nasopharyngoscopy were also normal. A series of chest radiographs from 3 years ago showed that the wire had migrated from the right AC joint to the left side of his neck (Fig. ). Computed tomography angiography was performed to evaluate the position of the K-wire regarding the major vessels. The wire was removed by exploratory neck dissection under C-arm fluoroscopy assistance. The wire was found beneath the carotid sheath and removed by gentle traction along its axis (Fig. ). His postoperation recovery was uneventful, and he was discharged 4 days later.
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.