Foreign body - forearm

Case contributed by Dr Maulik S Patel

Presentation

Swelling and pain to the volar aspect of the mid to distal forearm. Patient had a background of wood splinter injury 2-3 months previously.

Patient Data

Age: 25 years
Gender: Male
Photo

There is soft tissue swelling on the volar aspect of the distal forearm.

Ultrasound

There is a linear echogenic focus ( about 33 mm long ) at site of clinically visible swelling. It is a foreign body - wood splinter. It is in flexure digitorum superficialis muscle belly. There are two other wood splinters ( about 10 - 12 mm long ) and few smaller ( < 5 mm long ) near distal end of larger foreign body mentioned above. There is collection around these foreign bodies which is causing clinically visible swelling.

There is another wood splinter ( about 30 mm long ) just proximal to above mentioned foerign body. It is also in flexure digitorum superficialis muscle belly; however, a deeper level. There is granuloma ( about 15 x 10 mm ) around this foreign body extending to deeper profundus muscle.

Median nerve, ulnar nerve are normal. Ulnar and radial arteries are patent.

Photo

Intra-operative photoes showing foreign bodies - wood splinters. The distal foreign body was more superficial and the more proximal foreign body was deeper.

Photo

Two longer - larger and other smaller wood splinters.

Case Discussion

Young male presented with history of wood splinter injury to forearm 2-3 months prior to presentation. Ultrasound shows multiple foreign bodies which were removed surgically.

Intra-operative photos courtesy of operating surgeon Dr Niraj Patel.

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