Management of huge and extraordinary metal-penetrating injuries to the hand

Abstract

Objective: Foreign-body and penetration injuries of the hand are common emergencies. Metallic foreign bodies are common among all foreign masses; however, the examination of huge bodies differs from that of other metallic masses. The purpose of this study was to clarify an algorithm for the management of the huge metallic masses via our therapeutic approaches for metal-penetrating injuries.
Material and Methods: Seven patients who had a huge, metallic object-penetration injury to their upper extremity were included in our study. Patients were classified according to the age, injury type, character of metallic body, injury zone, diagnostic methods, anesthesia type, and treatment received, and an algorithm to approach the management of foreign metallic bodies was clarified.
Results: The causes of injury were knitting hook, iron fence, mixer, and metal nail. Plain radiography was performed for all patients. Prophylactic tetanus was administered and urgent exploration in the operation room under tourniquet followed by foreign-body extraction through cutting and not pulling were conducted. No residue was retained.
Conclusion: Many patients referred to emergency services with foreign bodies. For diagnosis, the patient’s history and a minimum of two-way radiograms are crucial. For treatment, we recommend surgical exploration under general anesthesia and tourniquet and extraction of the metallic body by cutting and not pulling without retaining any residual mass in the operation room.

Cite this paper as: Akdağ O, Yıldıran G, Karameşe M. Management of huge and extraordinary metal-penetrating injuries to the hand. Turk J Surg 2018; 34: 117-120.
This study was presented at the “14th National Congress of the Turkish Society for Surgery”, Bursa, Turkey.

Authors declared that the research was conducted according to the principles of the World Medical Association Declaration of Helsinki “Ethical Principles for Medical Research Involving Human Subjects”.

Written informed consents were obtained from patient who participated in this study.

Externally peer-reviewed.

Concept - G.Y., O.A.; Design - G.Y., O.A.; Supervision - O.A., M.K.; Resource - O.A., G.Y., M.K.; Materials - G.Y.; Data Collection and/or Processing - G.Y., O.A.; Analysis and/or Interpretation - G.Y., O.A.; Literature Search - O.A., G.Y.; Writing Manuscript - G.Y., O.A.; Critical Reviews - O.A., M.K.

The authors have no conflicts of interest to declare.

The authors declared that this study has received no financial support.