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 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.