Gulati Divesh, Agarwal Anil
Department of Orthopaedics, UCMS-GTB Hospital, Shahadara, Delhi, India.
Ulus Travma Acil Cerrahi Derg. 2010 Jul;16(4):373-5.
We report herein a case in which symptoms appeared eight years after the apparent trauma, which had been forgotten. Surgery yielded a wooden foreign body in the forearm. A 10-year-old boy presented with a six-week history of pain followed by swelling in his left forearm occurring after a trivial blunt trauma, with occasional bouts of fever. There was an oval swelling (7 cm x 3 cm) on the posterolateral aspect of the upper third of the left forearm. Tenderness, increased local temperature and elicitable fluctuation, with no scars or wounds (signs of trauma), were noted. Radiographs of the forearm revealed a soft tissue swelling but no fracture, periosteal reaction or other bony lesion. Aspiration of the swelling yielded purulent material (gram stain negative). The abscess was drained and exploration of the cavity revealed a 14 mm long slender wooden foreign body embedded in granulation tissue. On retrospective enquiry, the family reported that the child had sustained a penetrative injury eight years before after falling on a broomstick. Presence of a foreign body must be kept in mind while investigating a suspicious swelling on the extremities. A thorough history and careful imaging are the keys to diagnosis.
我们在此报告一例病例，症状在明显创伤八年后出现，而该创伤已被遗忘。手术在前臂取出一个木质异物。一名10岁男孩在一次轻微钝性创伤后，左前臂出现六周的疼痛，随后肿胀，偶尔伴有发热。左前臂上三分之一的后外侧有一个椭圆形肿胀区（7厘米×3厘米）。有压痛、局部温度升高和可引出的波动感，无疤痕或伤口（创伤迹象）。前臂X线片显示软组织肿胀，但无骨折、骨膜反应或其他骨质病变。肿胀部位穿刺抽出脓性物质（革兰氏染色阴性）。脓肿切开引流，探查脓腔发现一个14毫米长的细长木质异物嵌入肉芽组织中。经回顾性询问，患儿家属称孩子八年前摔倒在扫帚上，受到了穿透伤。在检查四肢可疑肿胀时，必须考虑到异物的存在。详尽的病史和仔细的影像学检查是诊断的关键。
