Missed foreign bodies in the hand: an experience from a center in Kashmir

Salati, Sajad Ahmad; Rather, Ajaz Ahmad

doi:10.3402/ljm.v5i0.5083

Cited by 24 publications

(19 citation statements)

References 32 publications

(39 reference statements)

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“…10 Salati et al reported that only 10% of his cases attended within 2 weeks of injury, rest of 90% came after two weeks. 8 Our findings are comparable to that of Salati as two third of our patients presented after two weeks of initial injury.…”

Section: Discussionsupporting

confidence: 90%

“…Our finding contrasts to the observation of Salati et al and Mohammadi et al who reported a gender difference in foreign body injury patterns with predominant involvement of males. 8,9 The difference is probable due to more frequent involvement of our women in household, farming and cattle grazing activities.…”

Section: Discussionmentioning

confidence: 99%

“…8,9 The time of presentation since the initial injury to emergency department or outpatient clinics is variable in different reports. Our observation contrasts to that of Levine et al who reported majority of their patients presenting within 48 hours.…”

Section: Discussionmentioning

confidence: 99%

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Presentation and Management of Soft-Tissue Foreign Bodies in a Teaching Hospital of Western Nepal

Joshi¹,

Dwivedi²

2016

J Lumbini Med Coll

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Introduction: Accidental penetrating injuries with foreign bodies are a common presentation in hospital's emergency rooms. If missed, these bodies can remain dormant or result in a wide range of complications. This study evaluated the characteristics of patients, presentation and management who suffered foreign body embedded in soft tissue at a teaching hospital of Western Nepal. Methods: The study was conducted at Department of Orthopaedics, Lumbini Medical College Teaching Hospital from September 2013 to August 2015. All cases confirmed to have a foreign body in soft tissue were enrolled. Surgical exploration with removal of foreign body was carried in operating room under tourniquet control. The patient demographics, cause of injury, nature of foreign body, occupation of the patient, diagnostic yield of radioimaging, procedures undertaken for retrieval of foreign body, and complications were recorded. All patients were followed-up up to five months. Results: Total 28 patients, nine (32.1%) males and 19 females (67.9%) were observed. The mean age was 35.6 yr (SD=11.1). Housewives (n=14, 50%) were the common sufferers. Most of our patients (n=17, 60.7%) presented two weeks after injury. Accidental prick while cutting grass or tree was the common mode (n=13, 46.3%) of injury and among foreign bodies, wooden or vegetative were the commonest (n=19, 67.9%) observed. Among the extremities, hand (n=10, 35.7%) and foot (n=5, 17.9%) were commonly affected. All patients had successful surgical exploration and retrieval of the foreign bodies under anesthesia and tourniquet control in operating room. Image intensifier was employed in seven cases to locate the foreign bodies per-operatively. Wound infection developed in 14.2% (n=4) of patients, all of whom were managed successfully with oral antibiotics. None of the patients required re-hospitalization. All patients were fine at final five months follow up. Conclusion: Managing foreign body embedded in the soft tissue are challenging. Surgical exploration under tourniquet control suffice a definitive management. At times, image intensifier is required to locate the foreign body.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Presentation and Management of Soft-Tissue Foreign Bodies in a Teaching Hospital of Western Nepal

Joshi¹,

Dwivedi²

2016

J Lumbini Med Coll

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“…[3] A non healing wound or discharging focus, chronic pain and visible lump are common clinical features associated with retained foreign bodies. [4] The clinical symptoms may remain dormant for months or years to present later with localised pain or other pathology. Our case was a child and small size of splinters did little to affect his activities of daily living when after eight months the mother noted pain on local injury site.…”

Section: Discussionmentioning

confidence: 99%

Magnet assisted retrieval of metallic foreign body from ring finger of a child.

Dharmshaktu¹,

Khan²

2015

Int Jour of Biomed Res

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Penetrating or piercing injuries are not uncommon in paediatric age with considerable disability if neglected or managed in a suboptimal way. Both metallic and non metallic objects have been associated with various types of penetrating injuries. Many a times certain broken piece of the object is retained and later becomes painful and equally difficult to remove. Very minute pieces or splinters of metallic objects can be successfully retrieved with the help of magnet to assist in the process. We describe our successful experience with the same idea implemented while removing a small splinter of needle from a slender digit of a toddler. Keywords: Pediatric, Foreign body, Musculoskeletal, Injury, Management, exploration 1.IntroductionAcute Penetrating trauma can be labeled as an elaborate group that is part of human injuries since ages. Both non metallic or metallic foreign bodies cause immediate and remote damages with treatment depending on the clinical features at the time of its presentations. Late complications of neglected musculoskeletal foreign bodies include bursitis, synovitis and arthritis.[1] Early identification and management is easier and cost effective method to deal with these foreign bodies. A high index of suspicion and clinical acumen is warranted to diagnose the embedded foreign bodies. Metallic foreign bodies usually are visible well on plain radiographs and biplanar view gives the idea of its location to some extent. Ancillary investigations like ultrasonography or magnetic resonance imaging (MRI) are reserved for suspected cases.[2] The confirmation is also necessary in view of medicolegal formalities about retained ones. The meticulous retrieval of the object without jeopardising the vital adjacent anatomy in minimal invasive way is a recipe for good functional outcome and uncomplicated healing. Case ReportA two and half year old child was brought by his mother to us with complaints of pain and tiny bump over volar aspect of his distal phalynx of left ring finger. She gave history of accidental penetrating injury with sewing machine needle to the index finger of child eight months back. The child placed his left ring finger accidently under the sewing needle while she was operating the manual sewing machine at home. The child cried and withdrew the hand and the needle broke into two halves. The two pieces were removed by the mother instanteneously as they were laid exposed above the skin. The bleeding and wound were managed by a local practitioner with uncomplicated healing and the child returning to his activities of daily living. He had no complaints till last week saw local pointing pain at the site of original wound with tiny bump felt by the child (Fig.1a).A plain radiograph of the child with clinical suspicion of a retained foreign body was advised to show two minute radio-opaque splinters in the pulp of distal phalynx of index finger (Fig.1 b, c).There was minimal discomfort and entry site, pain on deep palpation and adjacent joint motion was normal. There was no history sugg...

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“…Foreign body injury was most frequently in the foot and the hand and most commenly seen in young ages (Nagendran, 1999;Salati and Rather, 2010). Foreign bodies may be composed of different materials such as metal, glass, wood, plastic, etc.…”

Section: Introductionmentioning

confidence: 99%

An Interesting Piercing Injury of the Hip with a Steel Bar

Uzun

Çıraklı

2016

Mid. Black Sea J of Health Sci.

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Foreign body injuries are not uncommon. Foreign body penetration may occur in almost any part of the body. A piercing or penetrating injury of the hip or pelvis by a steel bar is a rare condition compared with the extremities. Our study aims to highlight this interesting injury and its treatment. We report the case of a 19-year-old man who was working in a construction when he fall that resulted in the piercing of the hip with a long steel bar and our treatment strategy. The patients achieved good results without neurovascular injury. Our study highlights that intervention should be done at operating room in case we confront any neurovascular injury and its complications.

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Missed foreign bodies in the hand: an experience from a center in Kashmir

Cited by 24 publications

References 32 publications

Presentation and Management of Soft-Tissue Foreign Bodies in a Teaching Hospital of Western Nepal

Presentation and Management of Soft-Tissue Foreign Bodies in a Teaching Hospital of Western Nepal

Magnet assisted retrieval of metallic foreign body from ring finger of a child.

An Interesting Piercing Injury of the Hip with a Steel Bar

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