PMC4772416_01
(a and b) Preoperative X-rays and three-dimensional computed tomography studies demonstrating a 3-part proximal humeral fracture; (c and d) Postoperative X-rays in anteroposterior and transthoracic views
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F1
Examinations showed a 3-part fracture of the proximal left humerus, accounting to the Neer's classification (AO/ASIF: 11-B2) [Figure 1a and b]. The first two wires were retrograde nonthreaded bent wires inserted at the deltoid "V" level, while the latter was an anterograde threaded wire percutaneously introduced to fix the great tuberosity [Figure 1c and d]. Two days after surgery, the patient was discharged from the hospital.
(a and b) One month follow-up X-ray control showing migration of the anterograde threaded wire; (c and d) Computed tomography study performed to defi ne the relationship between the wire and intrathoracic vital organs, demonstrating the wire close to the diaphragm and posterior and inferior to the left ventricle, without organ damage
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F2
X-rays demonstrated the intrathoracic migration of the threaded wire used for tuberosity fixation [Figure 2a and b]. It revealed the device was migrated through the fifth intercostal space to the left lung parenchyma, without the signs of pneumothorax, nor bleeding [Figure 2c and d].
(a) Fibrin-coated entry point of the wire in the left lung; (b) Thoracoscopic views of the wire removal; (c) The removed wire
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F3
This allowed the foreign body to be visualized and easily removed [Figure 3].