Removal of Neglected Foreign Body in Upper Extremities

PURPOSE: To describe the clinical manifestations, diagnosis, and treatments in the patients with delayed diagnosis after foreign body injury. MATERIALS AND METHODS: Seventeen patients with foreign body injury, who had delayed diagnosis more than two months, from January 2000 to August 2008, were enrolled in the present study. The clinical manifestation, materials, locations of foreign bodies, and diagnostic methods were assessed in this study. In addition, we investigated the treatment in the all patients. RESULTS: The interval between injury and removal surgery varied from two months to 16 years. The most common clinical manifestations were foreign body sensation and tenderness (13/17). Glasses (9/17), woods (3/17), needles (2/17), and pencil leads (2/17) were the common foreign bodies. In addition, the most common location of foreign body was palm (7/17), followed by finger (4/17) and wrist (3/17). In the major portion of patients (13/17), the diagnosis was made by simple roentgenogram at the time of presentation. Ultrasonogram (US) or magnetic resonance imaging (MRI) was performed in the residual four radiolucent foreign bodies. In the all 17 patients, surgical removal was performed. CONCLUSIONS: A doctor should perform the scrupulous history taking and physical examination when diagnosing injury by foreign body. In patients with history of prior surgical treatment due to laceration or penetration by foreign body, active examination, radiological diagnosis including roentgenogram, US, and MRI, and surgical removal are recommended.

A Multi-center, Double-blind, Randomized and Comparative Clinical Study for the Safety and Analgesic Effect after four-week-treatment with Neurotropin(R) in Patients with Low Back Pain: Compared to Aceclofenac / 대한척추외과학회지

STUDY DESIGN: A Multicenter double-blind randomized clinical study comparing Neurotropin and Aceclofenac. OBJECTIVE: To evaluate the analgesic effect, efficacy and safety of Neurotropin in patients with low back pain. SUMMARY OF LITERATURE REVIEW: Non steroidal anti inflammatory analgesics are used as the main medical treatment in patients with low back pain. However, complications, such as gastrointestinal or cardiovascular problems, have been well documented. Neurotropin acts to recover the analgesic state arising from a decrease in pain threshold and has a completely different mechanism to that of existing anti-inflammatory and narcotic analgesics, with its action of restoring the immune system having been confirmed. MATERIALS & METHOD: 376 patients with back pain were randomly divided into two groups; one group was administered Neurotropin and the other Aceclofenac. The overall improvement after 4 weeks was used as the first efficacy variable, and with the second efficacy variable the improvements in spontaneous pain, tenderness, motion pain, radiating pain, severity, pain intensity, and the overall severity and Oswestry Disability Indices were used as the evaluation criteria. To evaluate safety, the abnormal clinical response and alternations on physical examination and the clinical laboratory values were used. RESULTS: A total of 358 patients received the experimental and comparison drugs, of which 351 were evaluated for safety. The overall improvement after 4 weeks, severity of symptoms, overall severity, and the pain intensity and Oswestry Disability Indices were decreased in both groups, but the differences between the two groups were not statistically significant. The overall decrease in the severity was greater in the Aceclofenac group, but both groups had statistically meaningful decreases after the administration of the drugs. i.e. Adverse drug reactions were less in the Neurotropin group, but these showed no significant statistical difference. CONCLUSIONS: Neurotropin and Aceclofenac are equally effective in patients with low back pain, but in terms of safety from a clinical view point Neurotropin is more reliable.