A 70-year-old man with a past history of pneumoconiosis underwent a surgery for the fracture of the distal end of the right clavicle with Kirschner wires and soft wire at a local hospital. He had sustained slight chest pain since 6 months after surgery and visited another hospital because his chest pain was aggravated about 2 months later. Radiographs and CTs showed the migration of the Kirschner wire, sticking into the trachea. He visited our hospital and the tip of the Kirschner wire was observed by a bronchoscopy. The migrated Kirschner wire was directly identified and removed through a right thoracotomy. The remaining Kirschner wires and soft wire were also removed from the clavicle. His postoperative course was uneventful. Perforation of the trachea by a migrated Kirschner wire is very unusual. In this case, pneumothorax did not occur when the migrated Kirschner wire perforated the pleura probably because of the pleural adhesion due to pneumoconiosis, causing only slight chest pain. The aggravation of chest pain was probably attributable to the perforation of the trachea by the further migrated Kirschner wire. When a Kirschner wire is used for fracture surgery, it should be inserted certainly into bone and its end should be bent sufficiently to prevent it from migrating.
