Retained Foreign Body in a Digit

Retained foreign bodies in extremities are common. They may remain asymptomatic or may develop a wide range of complications. We report a case of a 7 years boy who suffered from painful movements of the left thumb due to retained foreign body.

A 7 years old left-handed boy with no past medical history presented with pain at the base of his left thumb when he holds the pencil for last six months. On examination, there was a faint 4mm scar over the dorsal surface of the proximal phalanx of left thumb. This scar resulted from an injury sustained while playing about one year ago. The injury was managed conservatively with wound dressings. Radiographic film of left hand (Fig 1) revealed a radio-opaque foreign body in relation to proximal epiphysis of the proximal phalanx of the affected thumb. Surgical exploration was performed under conscious sedation and digital block with 1% xylocaine, proximal tourniquet control, and fluoroscopic guidance. Magnification was achieved with the help of magnifying loupes. A stony foreign body of about 3mm diameter was retrieved without complications. The patient was symptom free at three months follow-up. It is stressed that the possibility of foreign bodies should be kept in mind in penetrating injuries of hands and ruled out by appropriate imaging , to prevent later complications.

The authors thank the guardians of the patient to allow the case history and images for publication for academic purposes.