Liaw Frank, Murray Odhrán, Tan Yan Yu, Hems Timothy
Queen Elizabeth University Hospital, Trauma & Orthopaedics, Glasgow, Scotland.
Royal Stoke University Hospital, General Surgery, Newcastle-under-Lyme, Newcastle, England.
Open Orthop J. 2018 Jun 14;12:203-207. doi: 10.2174/1874325001812010203. eCollection 2018.
Diabetic peripheral neuropathy puts patients at increased risk of acute injury by foreign bodies and also contributes to delayed presentation and diagnosis.
We describe a 57-year-old patient with poorly controlled type 1 diabetes who presented with a three-week history of worsening swelling and erythema in the metacarpophalangeal joint of his left thumb. He denied any previous trauma or injury and was initially treated with intravenous antibiotics. Subsequent imaging revealed septic arthritis and osteomyelitis secondary to a retained foreign body, which was surgically removed in theatre.
This is the first reported case of a retained foreign body in the hand of a diabetic patient, and demonstrates the importance of early radiological imaging of peripheral limb injuries in high-risk patients.
糖尿病周围神经病变使患者遭受异物急性损伤的风险增加,并且还导致就诊和诊断延迟。
我们描述了一名1型糖尿病控制不佳的57岁患者,其左拇指掌指关节出现肿胀和红斑加重的三周病史。他否认既往有任何外伤或损伤,最初接受静脉抗生素治疗。随后的影像学检查显示继发于异物残留的化脓性关节炎和骨髓炎,该异物在手术室通过手术取出。
这是首例报道的糖尿病患者手部异物残留病例,证明了对高危患者周围肢体损伤进行早期放射学检查的重要性。