21 An Unusual Bone Reaction to an Organic Foreign Body in the Hand

Abstract

Everyone is cognizant of the frequency of penetrating injuries to the palm of the hand and to the fingers by various foreign bodies, such as splinters of wood, thorns or small projectiles. If the foreign body is not removed or cannot be phagocytosed during the inflammatory reaction, the end stage is encapsulation with fibrous tissue and the formation of a foreign-body granuloma. Many studies, both clinical and experimental, have been reported on the reaction of bone and soft tissues to relatively inert metals and metallic implants. However, a review of the literature since 1930 fails to reveal any significant reports or studies on the reaction of bone to certain common organic foreign bodies. The case to be reported stimulated much interest and speculation at our hospital. The bone changes were unusual, and the radiologist hesitated to make any definite diagnosis. The history was also somewhat unclear as to whether or not a foreign body ever had entered the patient's hand. Because of the similarity of the roentgenologic picture to a possible malignant process, and because of the probable frequency of these types of injuries, one feels justified in reporting this very interesting case of a foreign-body granuloma in the hand associated with osteolytic and osteo-blastic bony reaction.