Malik Muhammad Khalid, Lubna Habib, Masoom Raza Mirza, Attaur Rehman.
Foreign body in limb: does removal indicated?.
J Pak Orthop Assoc Jan ;21(2):26-30.

Objective: To present management of implanted foreign bodies in limbs resources constraint set up. Design & Duration: Prospective descriptive study conducted over a period of six months from February 2008 to January 2009. Setting: Orthopaedic unit II, Civil Hospital and Hamdard University Hospital, Karachi Patients and methods: All consecutive patients with the diagnosis of implanted foreign bodies in limbs were included in the study. Their detailed history especially with reference to history of trauma, the diagnostic modality used and treatment was recorded in a pre designed Performa and result was analyzed. Result: A total of 37 patients were included in this study. Abscess formation was the commonest presentation. The history was diagnostic for the presence of foreign body in 33 patients and the period of harboring foreign body since trauma was from one day to 3 years. Majority of patients (21) presented with implanted foreign body in hand, 4 in feet, 2 in arm, 3 in forearm, 5 in thigh/gluteal region, and 2 in knee joint. Plain radiography was performed to confirm the diagnosis and it was helpful in 31 patients. In remaining six patients no radio opacity was seen on plain radiographs. Among these six patients, two of them had lytic lesions on plain radiography. Due to strong suspicion ultrasonography was performed in these two patients which confirmed the diagnosis. The diagnosis of implanted foreign body was confirmed in remaining 4 patients at exploration. Needle was the commonest foreign body found in 13 patients. 36 patients underwent exploration for the removal of foreign body. One patient who presented with multiple pallets in and around the knee joint, no intervention was performed and his management remained a question. Conclusion: Presence of foreign bodies in limbs is not life/limb threatening but may cause troublesome complications and need removal even if asymptomatic.

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