A 60-year-old woman presented to us with pain over medial aspect of right knee joint. The pain was non radiating. The pain was relieved by rest and was exacerbated by squatting and sitting cross legged. The patient had difficulty in climbing stairs. On physical examination there was tenderness along the medial aspect of knee joint and a curved scar mark was present over the anterior aspect of knee joint (). While history taking the patient told us that she had a patella fracture around 4 years back which was treated by open reduction and internal fixation and she subsequently underwent implant removal 2 years back. The patient had full range of motion (ROM) at knee joint (Figs. , ) and moderate pain was observed on medial side while flexing and extending knee joint. There was no history of any recent trauma to knee joint. A provisional diagnosis of osteoarthritis knee joint was made and weight bearing standing antero-posterior and lateral x-rays ofleft knee joint were ordered. On X-rays it was found that multiple pieces of broken circlage wire were present around knee joint and one piece had migrated posteriorly (). On examination patient did not had distal neurovascular deficit and patients pain was not related to these broken pieces, rather it was due to degenerative changes in the knee joint. It is believed that the surgeon who did implant removal removed only the K wires leaving behind the circlage wires which broke into multiple pieces over the passage of time due to the repeated stresses at knee joint. Patient was advised to undergo total knee replacement along with subsequent removal of broken hardware as potential undue complications can occur because ofbroken hardware in the form of damage to neuro vascular structure due to migration of pieces posteriorly. It was also explained to the patient that cases have been reported where broken pieces migrate to heart and sternum and produce life threatening complications. However, patient refused to undergo any type of surgery. she was warned and told to be alert whenever the nature of her pain changes or she experiences new onset of symptoms which is different in character from the pain she is experiencing now and was kept on regular follow up.
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.