A Case of Kirschner Wire Penetration into the Abdominal Cavity During Surgery for Femoral Neck Fracture

Abstract

An 88-year-old woman was brought to the orthopedic department of our hospital with a right femoral neck fracture. During open reduction and internal fixation, a Kirschner wire penetrated the femur and hipbone and strayed about 20 cm into the abdominal cavity. Since the vital signs of the patient were stable, a CT was carefully performed to assess any injuries to the intra-abdominal organs and great vessels. The CT findings led to the suspicion of damage to the right external iliac vein. On laparotomy, the wire was found to have penetrated the right external iliac vein and small mesentery, although there was no intra-abdominal bleeding. Blood flow of the right external iliac vein was blocked on both sides of the injured area with bulldog forceps, and the injured area was sutured. The postoperative course was uneventful, and the patient was discharged from our hospital about a month later. While in this case, there were fortunately no life-threatening complications or injuries to the intra-abdominal organs, it is necessary to take instant decisions on the appropriate treatment in such cases, depending on the patient’s condition, decide whether to administer the various treatments.