Foreign Bodies in Tendons

Abstract

At the National Institute of Traumatology in Budapest, a search has been made for foreign bodies in tendons over the last 15 years. 53 foreign bodies have been found in 931 tendons removed at operation and 45 foreign bodies in 950 tendon samples at autopsy. The foreign material was found to be organic in 29 cases, metal in 20 cases and plastic in six cases. In the others, glass, sand, mineral grease and textiles could be detected. In 33 cases the material could not be identified. The foreign bodies were found in the tendons of the upper extremities in 51 cases and the lower extremities in 47 cases. Foreign bodies in the tendons were more likely to cause problems in the upper limbs than in the lower limbs: these problems were purulent tendonitis, necrosis, foreign body granuloma, fibrosis and peritendonitis and calcification.

The past, present and future in scaffold-based tendon treatments

“…The use of PLGA and PCL has been problematic, with in vitro data showing poor tendon cell adhesion, reduced proliferation rate and phenotypic drift [360,427]; with preclinical in vivo data showing poor cellular infiltration and mechanical properties compared to controls [428]; and with clinical evaluations showing problems with cell lysis, anchor failure, macrophage stimulation and allergic responses [429,430]. This high failure rate has been attributed to their hydrophobic nature and their lack of cell recognition signals that prevents cell attachment [391,[431][432][433][434]. To this end, scaffold-free therapies based on the principles of tissue engineering by self-assembly / cell-sheet technology are slowly, but surely, gaining more scientific and technological interest.…”

Proximal migration of retained pencil lead along a flexor tendon in the hand

“…The hand is the most common site for foreign body injuries. [1] Glass, wood, and metal are the most common materials. [2] Pencil lead injuries often occur in school-age children, frequently in the head and neck region.…”

“…[2] One study reported that 4.7% of 950 tendons retrieved at autopsy had silent foreign bodies. [1] Another study reported that 38% of retained foreign bodies in the hand were missed by the first treating physician. [2] The patient in this case also presented with no symptoms, and there was no sign of inflammation during the exploration.…”

“…The hand is the most common site of foreign body injuries. [1] Among the numerous materials that can invade the hand, pencil lead penetration mainly occurs in school-age children. [3,4] As the history is often imprecise, adequate imaging is far more important.…”

Delayed presentation of a penetrating neck injury: diagnostic and management difficulties with retained organic material

“…In one autopsy study of patients with tendon injuries organic matter was associated with purulent tendonitis, necrosis, foreign body granuloma, fibrosis and peritendonitis and calcification. 10 Penetrating ingested foreign bodies can remain quiescent for years but can cause late mortality from diffuse and local suppurative processes especially if leading to vascular injuries. 11 …”