1/12. Migration of a K-wire from the distal radius to the heart.K-wires and Steinmann pins are used to provide internal fixation for fractures or osteotomies. In some instances, removal of the implant is planned and the implant is left long to facilitate its removal. In other instances, implant removal is not planned and the implant is cut off at the level of the bone. Migration of these implants to solid organs or body cavities has been reported. Extravascular migration may occur along tissue planes assisted by muscle motion. Large vessel penetration can occur and has been reported with subsequent migration of the implant to the heart. This case report documents the loosening of a K-wire used in the distal radius to supplement the fixation of a complex intra-articular fracture, migration of the implant along tissue planes, penetration into a peripheral vein, and continued migration of the implant to the heart. There are multiple reports documenting wandering bullets, venous catheter tips, and invasive monitoring devices in the extremities. This is only the second case report that the authors are aware of that confirms migration of an implant from the distal extremity to the heart.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/12. A technique for safe withdrawal of a catheter tip that hooks a coil loop.In cerebral aneurysm embolization with GDCs, coil movement and subsequent coil protrusion or migration may occur during catheter withdrawal. Coil migration or protrusion usually does not produce clinical problems, but sometimes it may do. Because the consequences of coil movement cannot be anticipated exactly, coil motion during a catheter withdrawal makes interventionists nervous. The authors report on a technique for safe withdrawal of a catheter tip that hooks a coil loop using a small soft coil.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
3/12. Late bullet migration into the knee joint.A 25-year-old active-duty police officer was found to have an intra-articular foreign body on radiographic study of his left knee joint. He had a gunshot wound to the midthigh 54 months prior to the presentation of symptoms. The bullet was lodged in the soft tissue without involving neurovascular structures. The patient complained of limited range of motion of the joint and a "rattle" sensation of the knee. Arthroscopically, a deformed metallic foreign body was found and retrieved. There was no injury inside the joint related to the loose body. These findings were consistent with a migrating bullet from the midthigh to the knee joint. The patient recovered uneventfully and returned to work.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
4/12. A novel approach to prevent repeated catheter migration in a patient with a baclofen pump: a case report.We report a novel solution to a problem of repeated catheter migration that may aid others caring for patients with catheter migration problems. Catheter migration is a frequently reported complication of intrathecal drug delivery systems. We report on an ambulatory patient with a baclofen pump for control of spasticity due to cerebral palsy and dystonia; the patient suffered repeated episodes of catheter migration. The ultimate solution to the migrations was to place a pediatric pump in the lower thoracic, paraspinal region with the catheter entering the thoracic spine directly adjacent to the pump, thereby minimizing the differential motion between the pump and the spine, which was thought to be the cause of the repeated migration. This solution has not been previously described. Paraspinal pump placement may eliminate repeated catheter migration for patients with intrathecal drug pumps.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
5/12. Intrapelvic migration of the trial femoral head during total hip arthroplasty: is retrieval necessary? A report of four cases.When testing intra-operative range of motion during a total hip arthroplasty procedure with trial components, there is potential for the femoral head to dissociate from the trial neck. We report the dissociation of the trial femoral head with migration of the head into the pelvis while checking for anterior stability of the total hip arthroplasty construct. Options for retrieval of the head are outlined.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
6/12. Creeping hair: an isolated hair burrowing in the uppermost dermis resembling larva migrans.A 55-year-old Japanese male presented with a slowly moving linear erythema that looked like an eruption of creeping disease, or cutaneous larva migrans. The eruption extended linearly along Langer's line of the lateral side of the abdomen to the lower back, leaving wave-like erythema. In the top third of the erythematous eruption, close examination demonstrated a black thin line, which was revealed to be a hair shaft by a shallow incision of the skin. After removal of the hair, the eruption diminished immediately, leaving a slight pigmentation. An ingrown pubic hair seemed to have migrated with the lower end forward along Langer's line, because of the arrangement of hair cuticle and the force of body motion. Linearly moving erythematous eruptions that look like that of larva migrans should be differentiated from creeping hair by close examination detecting burrowing hair.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
7/12. Hickman catheter tip displacement.In a series of 60 consecutive patients in whom Hickman catheters were placed for treatment of malignancy, four properly positioned catheter tips migrated secondarily from the superior vena cava to the ipsilateral jugular vein 2, 4, 21, and 25 days after placement. Three of the four patients had begun to have catheter dysfunction when the displacement was diagnosed. No satisfactory explanation for this rarely reported complication was evident in three of the cases. Maneuvers such as coughing, Valsalva's maneuver, and forceful heparin flushing produced no motion in three normally directed catheter tips in other patients observed under fluoroscopy. The phenomenon may be more common than previously reported. Evaluation of any new Hickman catheter dysfunction should include a chest x-ray film to ascertain the position of the catheter.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
8/12. Intrapelvic migration of Knowles pin through external iliac vein.Intrapelvic migration of a Knowles pin is rare. A case is reported of Knowles pin migration into the pelvis and through the external iliac vein. This was caused by a combination of excessive motion of the femoral neck nonunion and osteoporosis of the femoral head which allowed forward migration of the pin.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
9/12. Mycotic aneurysm of the external iliac artery caused by migration of a total hip prosthesis.A 77-year-old patient had a mycotic aneurysm of the left external iliac artery secondary to migration of a total hip prosthesis. Symptoms included pain, numbness, decreased hip motion, and a temperature of 38.5 degrees. The left leg was shortened, externally rotated, and swollen. There was anterior thigh hypoesthesia and quadriceps paralysis. A pulsatile mass in the lower left quadrant of the abdomen emitted a thrill and a loud bruit. A preoperative arteriogram facilitated diagnosis and planning of surgery. A transpubic femorofemoral bypass graft was used to reroute blood to the left lower limb, avoiding vascular reconstruction in the area of the aneurysm, a suspected site of infection. A false aneurysm was determined and was then isolated. The prosthesis was removed. During this operation, the acetabular component was found freely mobile within the false aneurysm. Cultures of the removed vascular tissue grew staphylococcus epidermidis. An arteriogram should be obtained prior to operation for any medial intrapelvic displacement of a total hip prosthesis to diagnose the extent of vascular involvement. physical examination may not reveal the aneurysm, but signs of neuropathy or venous thrombosis may suggest this diagnosis.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
10/12. Ender nailing of intertrochanteric and subtrochanteric fractures of the femur.Condylocephalic intramedullary Ender nailing of fractures of the proximal end of the femur offers four advantages. The operation is short and is minimally traumatic, with little blood loss. The patient returns to functional ambulatory status within a few days. infection of the fracture site and at the nail portals is a negligible risk, and the risk of delayed union and non-union is greatly reduced. The method has also introduced a group of new complications such as irritation at the knee, decreased range of knee motion, and distal and proximal migration and penetration of the nails, yet these problems did not cause failures of the method. osteoporosis was found to be a significant factor contributing to complications. External rotation deformity has not been a major problem in the present study and was improved by use of nails that had an anteversion bend. Delayed union was observed in only one patient with an intertrochanteric fracture which eventually healed. All subtrochanteric fractures healed within three months, which represents a favorable result in comparison with other methods.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
| | Next -> |