Department of Orthopaedic Surgery, Daegu Fatima Hospital, Daegu, South Korea.
Department of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, South Korea.
J Hand Surg Asian Pac Vol. 2020 Dec;25(4):423-426. doi: 10.1142/S2424835520500459.
Foreign bodies in the hand are common but easily and often missed in the initial evaluation of injury. Diagnosing retained foreign bodies is difficult due to radiolucent foreign bodies. Purpose of this study is to emphasize the need of consideration of foreign bodies in patients with chronic synovitis in hand. Twenty-five patients who had retained foreign body in soft tissue of hand with chronic inflammation symptoms were included. Ultrasonography was conducted in all of the patients. Patient age, sex, localization of foreign body, duration of symptom, history of injury, follow up period, complication, and biopsy results were recorded and reviewed. Also, patients' demographics and clinical results were retrospectively reviewed. Nine of the 25 patients diagnosed with a foreign body in the hand did not remember the initial presentation of injury. The average symptom duration (from injury to hospitalization) was 10.5 months (range 1-96 months). The middle finger and the proximal interphalangeal joint were the most common site of a retained foreign body (10 patients). All patients were diagnosed via ultrasonography and underwent surgery. Biopsy results showed mainly chronic inflammation, fibrosis, granuloma, and foreign bodies. Patient with symptoms of cellulitis, osteomyelitis, and palpable mass in hand for over a month without a diagnosis should be suspected of retained FBs.
手部异物较为常见,但在受伤的初始评估中很容易被忽视。由于异物不透射线,因此诊断残留异物较为困难。本研究旨在强调在手部慢性滑膜炎患者中考虑异物存在的必要性。
共纳入 25 例手部软组织内有慢性炎症症状且有残留异物的患者。对所有患者均进行了超声检查。记录并回顾了患者的年龄、性别、异物定位、症状持续时间、外伤史、随访时间、并发症和活检结果,并回顾了患者的人口统计学和临床结果。
在手部诊断为异物的 25 例患者中,有 9 例患者不记得最初的受伤表现。症状持续时间(从受伤到住院)平均为 10.5 个月(范围为 1-96 个月)。中指和近节指间关节是最常见的残留异物部位(10 例)。所有患者均通过超声检查诊断,并接受了手术治疗。活检结果主要显示慢性炎症、纤维化、肉芽肿和异物。
对于手部有蜂窝织炎、骨髓炎和可触及肿块的症状超过一个月且未明确诊断的患者,应怀疑有残留异物。