Tracheal ring fracture during a PercuTwist tracheostomy procedure.

Unlabelled: Because of difficult weaning from mechanical ventilation, a 59-yr-old man admitted for emergency cardiac surgery underwent a bedside PercuTwist tracheostomy on day 14 of his intensive care unit stay. We observed a double fracture of the second tracheal ring during the initial dilation process with the PercuTwist dilator, associated with distal migration of a cartilage fragment, which was avulsed from the anterior portion of the second cartilaginous ring.

Implications: Like other antegrade single-step techniques, the PercuTwist tracheostomy presents the risk of anterior tracheal wall damage during the initial stage of the dilation process.