A Potentially Dangerous Industrial Projectile Lodged in the Leg of a Steel Factory Worker

Abstract

Penetrating injuries due to fragments energized by an explosive event are life/limb-threatening and are associated with poor clinical and functional outcomes. Penetrating injuries are commonly inflicted in attacks with explosive devices. The extremities, especially the leg, are the most commonly affected body areas, presenting a high risk of infection, slow recovery, and the threat of amputation. This report presents a case of a young factory worker who sustained an injury to the leg with a foreign body lodged near the neurovascular bundle.A 44-year-old gentleman sustained a projectile injury while working in a stainless steel factory from the rula (steel rolling) machine with a foreign body getting lodged in the leg in March 2019. He was initially managed with wound care and didn't report any functional impairment. Gradually patient developed numbness and claudication symptoms of the foot over the next couple of years. He was subsequently operated on in 2021 for removal of the stainless steel foreign body encased in dystrophic calcification close to the tibial nerve and posterior tibial vessels. Interestingly the entry point of the foreign body was on the anterolateral aspect of the leg. The foreign body was removed using the postero-lateral approach to the tibia with careful dissection close to the neurovascular bundle. At a follow-up of 3 months, the patient is symptom-free with significant improvement of limb function.The authors propose that the foreign body crossed the interosseous membrane to get lodged close to the posterior tibial neurovascular bundle. In such a scenario, the patient was extremely lucky to have survived an amputation or significant functional injury of the limb. Proper protective equipment is needed not only for the torso but also for extremities to protect industrial workers from such limb-threatening injuries. Moreover, primary care physicians should be sensitised for the proper management of such injuries.

Analyzing the Role of Stress and Rumination in Tension-Type Headaches and Migraine

“…Supporting the findings of Khurana et al (2023), our study underscores the potential benefits of psychological interventions in treating headaches. These interventions, possibly addressing stress and rumination, could play a pivotal role in mitigating headache severity (Khurana et al, 2023). Additionally, interventions focusing on sleep quality and stress management, as discussed by Sullivan, Martin, & Boschen (2019), could be particularly effective in reducing both the frequency and intensity of headaches (Sullivan et al, 2019).…”

“…Furthermore, the correlation between lifestyle factors, such as physical exercise and screen time, and headache intensity noted by Kirchengast & Molnar (2022) is indicative of the broader implications of stress-related behaviors, including rumination (Kirchengast & Molnar, 2022). Supporting the findings of Khurana et al (2023), our study underscores the potential benefits of psychological interventions in treating headaches. These interventions, possibly addressing stress and rumination, could play a pivotal role in mitigating headache severity (Khurana et al, 2023).…”

“…This connection paves the way for future research to more concretely explore how rumination, specifically as a form of stress response, might influence the frequency, intensity, and overall management of migraine and TTH. Further emphasizing the significance of lifestyle factors, Khurana et al (2023) explored the efficacy of psychological interventions in managing pediatric headaches (Khurana et al, 2023). These E-ISSN: 2821-2738 interventions, potentially addressing issues such as rumination, proved effective in reducing the frequency of headaches in patients suffering from both migraines and TTH, thus improving their overall quality of life.…”

“…The cause of tension-type headaches and migraines can be both physical and psychological (Waldie & Poulton, 2002). Psychological interventions have been found effective but underutilized in the treatment of these headaches in pediatric patients (Khurana et al, 2023).…”

Embolización de cuerpo extraño por la raíz aórtica por lesión por arma de fuego: caso clínico de una paciente asintomática de diez años

“…Foreign body embolies that origin arterial system have mostly seen symptomatic and that's why they require emergency surgery. However, asymptomatic cases are followed conservatively, they can cause vascular related end-organ pathologies as time passes 6 .…”