Intraarticular Migration of Broken Patella Cerclage and Figure-of-Eight Wire

Iwan Budiwan Anwar; Seti Aji Hadinoto; Okkie Mharga Sentana

doi:10.3889/oamjms.2020.4732

Authors

Iwan Budiwan Anwar Department of Orthopaedic and Traumatology, Faculty of Medicine, Sebelas Maret University, Orthopaedic Hospital Prof. Dr. R. Soeharso, Surakarta, Indonesia
Seti Aji Hadinoto Department of Orthopaedic and Traumatology, Faculty of Medicine, Sebelas Maret University, Orthopaedic Hospital Prof. Dr. R. Soeharso, Surakarta, Indonesia
Okkie Mharga Sentana Universitas Sebelas Maret

DOI:

https://doi.org/10.3889/oamjms.2020.4732

Keywords:

Cerclage and figure of eight wire, Intraarticularly, Migrate, Patella

Abstract

BACKGROUND: Breakage of the wire commonly follows the procedure performed for displaced patellar fractures; nevertheless, there have not been many reports about wire fragment migration. To the best of our knowledge, there were only six documented cases of wire fragment intraarticular translocation.

CASE REPORT: A 47-year-old male patient, with a history of patella fracture 3 years ago, was treated with cerclage and figure-of-eight wiring, presented with severe restriction of knee movements for the past 4 weeks. X-ray and fluoroscopy examination showed cerclage wire had broken at multiple sites with one broken piece migrated posterior intraarticularly. This case is unique due to the size of the migrated broken cerclage wire, which was about only length 1.5 cm and diameter 1.25 mm attached to posterior lateral condyle which prevented its further migration; otherwise, it could damage neurovascular structures. This intraarticular piece of wire was removed successfully with fluoroscopy support.

CONCLUSION: Increased time-lapse from the initial surgery, the comminution of the fragment fracture, wire shape and size, and the incorrect placement of wire are the risk factors of intraarticular migration. We should educate the patient about the risks of hardware failure and possible migration with all patients receiving bone fixation with wires, and we can offer elective hardware removal as an option.

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