Kirschner wires caused unexpected complications of femoral neck fracture.

OBJECTIVE

To report a unique complication of the surgical treatment of femoral neck fractures.

CLINICAL PRESENTATION AND INTERVENTION: A young adult presented with lower abdominal pain and bleeding per rectum caused by rectal transfixion by Kirschner wires (K wires). The wires were used to fix a fracture on the neck of the femur during the Iraqi occupation of Kuwait. A plain X-ray showed an old united fracture of the neck of the left femur with coxa magna, mild coxa vara and mild secondary osteoarthritis of the left hip joint. Limited barium enema disclosed transfixion of the rectum by two radiopaque K wires in the pelvis with rectal track formation around them. The complication necessitated a laparotomy and a major dissection to remove the K wires.

CONCLUSION

The K wire provided an immediate solution during a difficult period. However, since it is not normally used for this purpose, it caused subsequent complications that were resolved by laparotomy and a major dissection.