Sequelae of Foreign Bodies in the Wrist and Hand

Abstract

Background Penetrating injuries to the hand are a common occurrence in the emergency room, and embedment of foreign bodies is suspected in many of these cases. The existing literature offers little information on retained foreign bodies. The aim of this study was to identify characteristics, determine prevalence, and observe outcomes for retained foreign bodies in the wrist and hand. Methods Four hundred thirty-seven consecutive hand and wrist radiographs in 437 patients from the emergency department of a level 1 trauma center were reviewed for the presence of retained foreign bodies. Location, size, number, and type of foreign body were recorded. Patient demographics, mechanism of injury, associated injuries, and treatment were obtained from medical records. All subsequent hospital and outpatient encounters were reviewed. Follow-up period was 18 months (range, 1-40). Results Of 437 cases, 65 patients (15 %) had at least one retained foreign body. Nineteen patients underwent removal of foreign body at initial presentation. The average size of foreign bodies removed was 6 mm, compared to 3 mm for those retained. Of 46 patients where the foreign body was left in situ, two (4 %) developed symptoms directly related to the retained foreign body. One of these patients underwent removal. Conclusions This study supports the safe removal of foreign bodies which are easily accessible or when part of a broader procedure to repair injured structures. Otherwise, we advocate expectant management for all other patients, as the likelihood of persistent symptoms is low and only 2 % of retained foreign bodies required removal later.

Retrospective evaluation of 377 patients with penetrating foreign body injuries: a university hospital experience (a present case of missed sponge foreign body injury)

“…In this study, male population is marginally involved [26]. Potini et al described hand injuries predominantly in males with an average age of 38 years [27]. In our knowledge, there is no study in the literature with a high population which describes FB injuries related to the extremities in different age groups.…”

Evaluation of Deep-Seated Soft Tissue Foreign Bodies According to Gender and Age Groups

“…Possible complications associated with residual pieces include; infection, persistent pain, swelling, migration, osteomyelitis, delayed healing, and pseudotumor (10,(16)(17)(18)(19)(20)(21)(22). Previous studies have reported higher risk of complication with glass and wood FB (23)(24)(25). Patients should be informed about the possibility of residual FB especially after removal of radiolucent FB, and patients with complaints during the follow up should be evaluated for residual FB.…”

Improved Detection of Foreign Bodies on Radiographs Using X-ray Dark-Field and Phase-Contrast Imaging

“…1 In 7% to 15% of these cases, retained foreign bodies can be found in the wounds. 2,3 Despite thorough examination, up to 38% of foreign bodies are overseen. 4 These missed foreign bodies can lead to complications such as persistent pain, infections, impaired wound healing, and loss of function.…”