A 52-year-old man underwent surgery for an AC joint dislocation 5 years ago. The dislocation was fixed using a K-wire. The patient did not require a follow-up appointment as he had no complaints. The patient's dominant extremity was right-sided and he was a retired construction worker. The patient presented to our outpatient clinic with swelling at the back of the neck. Radiological evaluation revealed that a broken tip of the K-wire used in the fixation of the AC joint dislocation had migrated to the back of the neck (). The broken K-wire was removed under local anaesthesia via mini-incision (). No intervention was performed for the AC joint. The remaining broken pin was not removed from the shoulder.
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 The drill was pushed till the subchondral bone and slowly the cannulated drill was withdrawn and with it the broken part came out ().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.