Removal of Neglected Foreign Body in Upper Extremities

ABSTRACT

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.