Neglected foreign body in contralateral limb in a traumatic transfemoral amputee-radiographs can be misleading

Abstract

【Abstract】Missed or neglected foreign bodies are not infrequent in surgical practice. This case report high-lights the fact that thorough clinical examination and de-tailed evaluation of trauma patients are very necessary so that any associated injuries or foreign bodies will not be missed and any unforeseen clinical or medico-legal compli-cations can be prevented. We present a case of a 35-year-old male patient who had traumatic transfemoral amputa-tion of the right lower limb with a clean laceration (size 2 cmx1 cm) over the medial aspect of the left thigh. Radio-graphs suggested a single radioopaque foreign body which proved misleading, as during surgical removal multiple radi-olucent and radiopaque foreign bodies were discovered. Postoperative ultrasound was performed and showed no retained foreign bodies. A secondary closure of the right thigh amputation was done and patient was discharged. At the last follow-up, 9 months after injury, the patient had no complaints, and both the amputation stump and the wound over the left thigh were healthy. Thus in the cases of re-tained foreign bodies, in addition to thorough clinical ex-amination and radiography, ultrasonograpy should be supplemented. And if required, use of CT scan as well as MRI should be also considered. Key words: Foreign bodies; Radiography; Diagnos-tic errors; Ultrasonography