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 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.