Arthroscopic Removal of a Missed Wooden Foreign Body in the Metacarpophalangeal Joint

We report a case of a missed wooden foreign body in the metacarpophalangeal (MP) joint of the right little finger following a workplace injury. The patient presented to our institution with a persisted pain and limited range of motion of the MP joint 1 week following the injury. Plain radiographs detected no foreign body or fractures. However, detailed examination as ultrasonography (USG) and computed tomography revealed the presence of a foreign body of 10 × 1.5 mm size in the MP joint capsule. The excision of the radiolucent foreign body was performed arthroscopically and was confirmed successful removal using intraoperative USG. The foreign body was recognized as a wooden piece. The patient was immediately pain free postoperatively and regained full range of motion. Arthroscopy can be a practical, reliable method to remove a radiolucent foreign body located in a small joint in a minimally invasive manner, and USG can help surgeons confirm no remnants left.

Bamboo in the brain: Impalement injury over orbito-cranial region via superior orbital fissure

Intracranial wooden foreign bodies due to transorbital penetrating injury sparing orbital globe are relatively rare with no reported cases till date. A multidisciplinary approach with multiple imaging modalities is needed for preoperative surgical planning. In this case report, we report a case of 3-year-old male who presented to our emergency department with history of fall from 5 feet with no vision over right eye. ~2cm cut injury with sutures in situ was present over nasal ridge with pus discharge. CT scan head showed foreign body over temporal region. Right fronto-temporo-orbito-zygomatic craniotomy with removal of foreign body was done. Deep seated abscess seen over temporal fossa was evacuated and post-operatively intravenous antibiotics was continued. Contrast enhanced CT repeated on 15th post-operative day showed no remaining abscess or foreign body. The patient was discharged on oral antibiotics. The wound healed completely with no improvement of vision in 1-week follow-up. Keywords: brain abscess, orbito-cranial penetrating injury, wooden foreign body

A CASE REPORT: CLINICAL INSIGHT ON RETAINED WOODEN FOREIGN BODY IN THE FOOT

The foot is the second commonest location for foreign bodies. The foremost common foreign bodies are needles, metal, glass, wood, and plastic. Though bimetal foreign bodies area unit promptly seen on plain film radiographs, radiolucent bodies like wood area unit pictured poorly, if at all.Though plain radiography is thought to be ineffective for demonstrating radiolucent foreign bodies, it's usually the primary imaging modality used. Herein, we present the case of a 42 years old man who had presented to the clinic with history of pain and swelling in his right foot. On examination, his vitals, heart sounds and breathing during auscultation were found to be normal. This particular individual had no other significant chronic illness. A brief history obtained from the patient revealed that penetrated wooden foreign bodies in his hind sole region. In view of his present complaints, he was successfully managed with antibiotics and pain relieving medications. Our patient comes under the small percentage of cases that had a missed diagnosis as the expulsion of the wooden particles occurred 3 months after the initial visit to the clinic. This case is being presented to enlighten understanding on clinical picture of retained wooden foreign bodies in foot.

Intraorbital wooden foreign body, legacy of a notorious scrap: a case report

Wooden foreign bodies are notorious to be fragile and get retained as bits and bobs in the orbit. A 50-year-old woman presented to casualty with complaints of loss of vision and pain in the right eye associated with discharge from a wound in right eye upper lid. On imaging, a wooden foreign body was seen as continuous track of air. Meticulous dissection and search were done to remove bits and bobs of the wood. Patient, however, after 15 days of primary surgery reported with pus collection over wound site. Keeping suspicion of remnant wooden body piece(s), imaging and further exploration were carried out, removal of a 1 cm residual wooden piece was done. Retained wooden foreign body should always be suspected in postoperative cases of intraorbital wooden foreign body with infection. A close follow-up and knowledge of the same stay useful to remove any needless apprehension both of patient and surgeon.

Orbital tumour or a retained foreign body? An uncommon case of missed diagnosis

We report a case who presented with decreased vision, significant hypotropia, proptosis and gross limitation of extraocular motility for one year. Suspecting an orbital tumour, we asked for a computed tomography of the orbit which revealed a mass lesion in the inferior orbit. However, incisional biopsy reported inflammatory infiltration. Diagnosing it as orbital inflammatory disease, a course of oral steroids was given for four weeks. It was only after the reduction in inflammation that a foreign body was palpable in the inferior fornix. Surgical exploration revealed a large wooden foreign body measuring 3.3 × 1 × 0.3 cm. Though intraorbital foreign bodies are not rare, ambiguous history, delayed presentation and nonspecific CT findings made this case diagnostically challenging.