Diagnosis and management of neglected foreign body foot in children

Abstract

Background: Foreign body related extremity trauma is uncommon in children and mostly involves lower limb. Such cases are prone to get neglected or missed and present at a later date with complications. Careful management at the outset can avoid such complications. Clinical suspicion followed by diagnostic imaging and retrieval of foreign bodies in cases with delayed presentation is vital. 

Methods: A retrospective case series analysis of foreign body foot, diagnosed and managed over a period of 6 years, was carried out at our institute with the aim to highlight clinical presentation and management of cases with a neglected foreign body foot.

Results: A total of 23 patients with diagnosis of foreign body foot were studied with 15 acute cases and 8 chronic neglected cases. The neglected cases ranged in age from 15 months to 96 months (Mean 58.87±28.32). Male to female ratio was 7:1. The history of trauma was concealed in 6 out of 8 cases. Three presented as abscess, 2 each as cellulitis and non-healing wound and one as a granuloma. Mean delay in foreign body removal was 57.12±67.94 days. Five patients had radiolucent while three had radiopaque foreign bodies.

Conclusions: Clinical suspicion aided by radiography and/or ultrasonography is pivotal in diagnosis. Removal of foreign body can be done by wound exploration under local anaesthesia in most of the cases.