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Intrathoracic Migration of Large-Fragment Screws After Failed Shoulder ArthrodesisA Case Report
Scott P. Ryan, MD1; Brian L. Puskas, MD1; Michael I. Ebright, MD1; Timothy E. Foster, MD1
1 Departments of Orthopaedic Surgery (S.P.R., B.L.P., and T.E.F.) and Cardiothoracic Surgery (M.I.E.), Boston University Medical Center, 850 Harrison Avenue, D2N, Boston, MA 02118. E-mail address for S.P. Ryan: scott.ryan@bmc.org. E-mail address for B.L. Puskas: bpuskas@yahoo.com. E-mail address for M.I. Ebright: Michael.ebright@bmc.org. E-mail address for T.E. Foster: Timothy.foster@bmc.org
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Investigation performed at Boston University Medical Center, Boston, Massachusetts

Copyright © 2011 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2011 Apr 06;93(7):e26 1-6. doi: 10.2106/JBJS.J.00320
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Orthopaedic implants used during upper-extremity surgery have been discovered in many locations. Kirschner wires and Steinmann pins have migrated into the thorax or mediastinum from local sites1-5 and from distant sites such as the phalanx6, patella7, and hip8. Although there are well-documented case reports on the migration of smooth and threaded Kirschner wires and Steinmann pins from the sternoclavicular and acromioclavicular joints into the thorax, the migration of large-fragment screws from the shoulder into the thorax has not been reported, to our knowledge. Screws are less likely to migrate because of their larger size and irregular shape. We present a case of intrathoracic migration of large-fragment screws after a failed shoulder arthrodesis. In accordance with the medical center institutional review board policy, the patient was informed about, and consented to, case publication.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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