TITLE:
Intravenous Fracture of a Peripheral Cannula at the Dorsum of the Hand in a Patient Who Used Walking Aids after Surgery
AUTHORS:
Chandana Karunathilaka, Vidura Wijesundara, Nalin Madushanka
KEYWORDS:
Peripheral Intravenous (IV) Cannulation, Cannula Fracture, Proximal Embolization
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.11 No.4,
April
27,
2021
ABSTRACT: In orthopaedic patients, peripheral intravenous (IV) cannulation is a common procedure for various clinical purposes. This patient was introduced with a 17G cannula in the basilic vein of the dorsal venous arch of the left hand prior to knee replacement surgery. Post knee surgery patients use walking aids for mobilization. Cannula which has been placed at the dorsum of the hand has a potential to bend at the neck of the cannula when the wrist bend while holding the walking aid. Repeated bending can result in fatigue fracture of the cannula neck. In this patient at the time of cannula removal, it was noted the catheter part is broken and proximal migration. Ultrasound guided localization was done and removed with a venotomy under local anesthesia. It is advisable to place peripheral venous cannulas well away from the wrist joint, which will prevent catheter bending and fracture. This is a very important point to consider when placing cannulas in orthopaedic patients who undergo surgical procedures.