title: Sequelae of foreign bodies in the wrist and hand.
abstract: BACKGROUND
  Penetrating injuries to the hand are a common occurrence in the emergency room, and embedment of foreign bodies is suspected in many of these cases. The existing literature offers little information on retained foreign bodies. The aim of this study was to identify characteristics, determine prevalence, and observe outcomes for retained foreign bodies in the wrist and hand.
  
  
  METHODS
  Four hundred thirty-seven consecutive hand and wrist radiographs in 437 patients from the emergency department of a level 1 trauma center were reviewed for the presence of retained foreign bodies. Location, size, number, and type of foreign body were recorded. Patient demographics, mechanism of injury, associated injuries, and treatment were obtained from medical records. All subsequent hospital and outpatient encounters were reviewed. Follow-up period was 18 months (range, 1-40).
  
  
  RESULTS
  Of 437 cases, 65 patients (15 %) had at least one retained foreign body. Nineteen patients underwent removal of foreign body at initial presentation. The average size of foreign bodies removed was 6 mm, compared to 3 mm for those retained. Of 46 patients where the foreign body was left in situ, two (4 %) developed symptoms directly related to the retained foreign body. One of these patients underwent removal.
  
  
  CONCLUSIONS
  This study supports the safe removal of foreign bodies which are easily accessible or when part of a broader procedure to repair injured structures. Otherwise, we advocate expectant management for all other patients, as the likelihood of persistent symptoms is low and only 2 % of retained foreign bodies required removal later.
authors.affiliation: Department of Orthopaedics, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, 140 Bergen Street, ACC D1626, Newark, NJ 07103 USA.
authors.forename: Vishnu C
authors.initials: VC
authors.lastname: Potini
authors.affiliation: Department of Orthopaedics, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, 140 Bergen Street, ACC D1626, Newark, NJ 07103 USA.
authors.forename: Ramces
authors.initials: R
authors.lastname: Francisco
authors.affiliation: Department of Orthopaedics, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, 140 Bergen Street, ACC D1626, Newark, NJ 07103 USA.
authors.forename: Benhoor
authors.initials: B
authors.lastname: Shamian
authors.affiliation: Department of Orthopaedics, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, 140 Bergen Street, ACC D1626, Newark, NJ 07103 USA.
authors.forename: Virak
authors.initials: V
authors.lastname: Tan
keywords: Foreign body; Hand; Treatment; Wrist