K wire migration into spinal canal: an infrequent cause of neurological morbidity - a case report.

INTRODUCTION: K wire is one of the most common implants used for fixation of acromioclavicular joint dislocation. The migration of K wire from the AC joint to the spinal canal is a rare occurrence. In this report, the authors present a case of a young adult who presented with weakness of the left upper limb secondary to migration of the K wire from the AC joint to the spinal canal.

CASE PRESENTATION: A 46-year-old male farmer presented with complaints of pain in the neck, tingling sensation in the left upper limb, and a tender palpable swelling on the left side of his neck with weakness of finger flexors and abductors. He had had an open reduction and fixation with K wire for Acromioclavicular dislocation three months back. CT confirmed the K wire is passing through the neural foramen between C5 and C6 vertebra and extending across the entire diameter of the spinal canal. Under intravenous anesthesia, a transverse skin incision was made over the prominent swelling on the neck, and the wire was gently removed. Minimal seepage of spinal fluid was observed, which stopped on its own after a few days.

DISCUSSION: Although AC joint stabilization by K wire fixation provides a safe and easy fixation with low morbidity, complications such as a loss of fixation or loosening can occur. Migration of K wire into a spinal canal is a well-known but infrequent complication. Resorption of bone, muscle action, and negative intrathoracic pressures associated with respiration and heat necrosis causes progressive loosening and dislodgement. Spinal migration is very dangerous because it can cause serious damage to the dura mater, spinal cord, and vertebral artery.

CONCLUSION: Early identification and removal of the K wire, once it has migrated from the site of use, is mandatory to prevent its grievous complications.