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

Özet

Objective: Foreign-body and penetration injuries of the hand are common emergencies. Metallic foreign bodies arecommon among all foreign masses; however, the examination of huge bodies differs from that of other metallicmasses. The purpose of this study was to clarify an algorithm for the management of the huge metallic masses viaour therapeutic approaches for metal-penetrating injuries.Material and Methods: Seven patients who had a huge, metallic object-penetration injury to their upper extremitywere 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 managementof foreign metallic bodies was clarified.Results: The causes of injury were knitting hook, iron fence, mixer, and metal nail. Plain radiography was performedfor all patients. Prophylactic tetanus was administered and urgent exploration in the operation room under tourniquetfollowed 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 historyand a minimum of two-way radiograms are crucial. For treatment, we recommend surgical exploration under generalanesthesia and tourniquet and extraction of the metallic body by cutting and not pulling without retaining anyresidual mass in the operation room.