Migration of a toothpick along the flexor tendon sheath in a lower extremity

Abstract

The most common foreign bodies seen in the foot are sewing needles, toothpicks, glass, and materials such as sand or silica. Foreign bodies in the foot are usually embedded, and surgical exploration and removal is usually necessary. Penetrating foreign bodies in the foot—particularly of organic origin, like wood—can cause cellulitis, osteomyelitis, abscess formation, and pseudotumor formation. Identification of foreign bodies in the foot can be challenging because they are often not radiopaque. However, foreign bodies in the foot do not migrate, in contrast to upper extremities, where foreign bodies are known to migrate. We report a case of a toothpick penetrating a child’s foot and moving proximally along the tendon sheath.