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.
A 27-year-old female patients with Grade II avascular necrosis of the head of femur secondary to sickle cell disease were taken to operating room for drilling and injection of autologous bone marrow derived osteoblasts and are recommended to use a smaller diameter K-wire for instillation of the cells. During the procedure, two guidewires were passed to centralize the area of injection. A 3.2 mm cannulated drill was used to drill on top of the guidewires. During drilling, 2 cm of the proximal guide wire broke () and we believe that this happened due to metal fatigue as the wire was used before couple of time. A discussion arose whether to leave the broken wire in situ. The risk of migration was always on the cards, hence, the guidewire was pushed back to the edge of the broken part. A 4.0 mm cannulated drill was used to drill over the broken wire (). The drill was pushed till the subchondral bone and slowly the cannulated drill was withdrawn and with it the broken part came out (). The rest of the procedure was carried out as per our protocol. shows the X-ray the right hip after 16 months of the surgery.