HS11P LONGEST RETAINED FOREIGN BODY IN THE HAND – AN 80‐YEAR FOLLOW‐UP

Abstract

While it is most often considered that foreign bodies in the hand should be removed, this case demonstrates that it is possible to have good functional and cosmetic result despite multiple foreign bodies embedded in tissues for long periods of times. Reasons to remove foreign bodies include to minimize risk of infection, foreign body reaction, mechanical interference, damage to deeper structures, psychological effects and medico‐legal sequelae and these are discussed in the context of this 80 year follow‐up for retained multiple foreign bodies in the hand. Upon literature review, there was no evidence of any other person living longer with foreign body in‐situ in the hand.With food scarce in Russia in World War I, this 93 year old man, aged 13 at the time, was given a gun to shoot rabbits for food but accidently shot through the volar surface of his hand. Treated only by the village senior, he had his hand dressed and continued without further examination or assessment, and without treatments including antibiotics or tetanus. Remaining fully‐functional his whole life, he was only referred to hand clinic with hand pain diagnosed as unrelated osteoathritis of the carpometacarpal joint of the ipsilateral hand. Thus, this unique case was encountered by chance upon examination and later verified through history and confirmed subsequently by x‐ray. Though having mild skin changes related to the palpable remnant metal, he has no obvious deformity and has full range of movement. X‐ray showed multiple shrapnel pieces embedded in the soft tissue of the dorsum of the hand. This unique case demonstrates it is possible to have good functional and cosmetic result despite long standing foreign bodies in the hand.