Korean Journal of Radiology

  • 제16권6호
  • /
  • Pages.1326-1331
  • /
  • 2015
  • /
  • 1229-6929(pISSN)
  • /
  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
권호 표지
DOI QR코드

DOI QR Code

Ultrasound-Guided Percutaneous Removal of Wooden Foreign Bodies in the Extremities with Hydro-Dissection Technique

  • Park, Hee Jin (Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital) ;
  • Lee, Sung Moon (Department of Radiology, Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Lee, So Yeon (Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital) ;
  • Son, Eun Seok (Department of Orthopaedic Surgery, Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Chung, Eun Chul (Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital) ;
  • Rho, Myung Ho (Department of Radiology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital) ;
  • Lee, Sun Joo (Department of Radiology, Inje University College of Medicine, Busan Paik Hospital)
  • 투고 : 2015.05.27
  • 심사 : 2015.08.19
  • 발행 : 2015.11.01
⟨ 이전 논문 다음 논문 ⟩

초록

Objective: We described the technique of ultrasound (US)-guided percutaneous removal of the foreign bodies (FB) with hydro-dissection in the radiologic department and presented video files of several cases. Materials and Methods: Four patients referred to the radiology department for US evaluation and US-guided percutaneous removal of the FBs in the upper and lower extremities between November, 2006 and November, 2013 were included in this study. The procedures started with US evaluation for the exact location and shape of the FB. A 5mm-sized skin incision was made at the site of the nearest point from the FB where no passing arteries or tendons were present. We adopted a hydrodissection technique to separate the FB from adjacent tissue using a 2% lidocaine solution. Injected anesthetics detached the FBs from surrounding tissue and thereby facilitated removal. After the tip of the mosquito forceps reached the FB, the wooden FBs were removed. Results: The mean time required for the entire procedure was approximately 20 minutes. There were no significant complications during the US-guided removal or long-term complications after the procedure. All 4 FBs were successfully removed from the soft tissue under US guidance. Conclusion: Ultrasound-guided percutaneous removal of the FBs with hydro-dissection in the radiology department is a less invasive and safe method over surgical removal in the operating room. Additionally, the use of a guide wire and serial dilator may help minimize soft tissue injury and facilitate the introduction of forceps.

키워드

참고문헌

  1. Budhram GR, Schmunk JC. Bedside ultrasound AIDS identification and removal of cutaneous foreign bodies: a case series. J Emerg Med 2014;47:e43-e48 https://doi.org/10.1016/j.jemermed.2014.01.033
  2. Callegari L, Leonardi A, Bini A, Sabato C, Nicotera P, Spano E, et al. Ultrasound-guided removal of foreign bodies: personal experience. Eur Radiol 2009;19:1273-1279 https://doi.org/10.1007/s00330-008-1266-5
  3. Anderson MA, Newmeyer WL 3rd, Kilgore ES Jr. Diagnosis and treatment of retained foreign bodies in the hand. Am J Surg 1982;144:63-67 https://doi.org/10.1016/0002-9610(82)90603-1
  4. Lee SM, Cho CH. Ultrasound-guided percutaneous removal of foreign body using hydrodissection and serial dilators. J Korean Orthop Assoc 2012;47:150-155 https://doi.org/10.4055/jkoa.2012.47.2.150
  5. Nwawka OK, Kabutey NK, Locke CM, Castro-Aragon I, Kim D. Ultrasound-guided needle localization to aid foreign body removal in pediatric patients. J Foot Ankle Surg 2014;53:67-70 https://doi.org/10.1053/j.jfas.2013.09.006
  6. Mulvaney SW. Ultrasound-guided percutaneous neuroplasty of the lateral femoral cutaneous nerve for the treatment of meralgia paresthetica: a case report and description of a new ultrasoundguided technique. Curr Sports Med Rep 2011;10:99-104 https://doi.org/10.1249/JSR.0b013e3182110096
  7. Peterson JJ, Bancroft LW, Kransdorf MJ. Wooden foreign bodies: imaging appearance. AJR Am J Roentgenol 2002;178:557-562 https://doi.org/10.2214/ajr.178.3.1780557
  8. Choudhari KA, Muthu T, Tan MH. Progressive ulnar neuropathy caused by delayed migration of a foreign body. Br J Neurosurg 2001;15:263-265 https://doi.org/10.1080/026886901750353728
  9. Jacobson JA, Powell A, Craig JG, Bouffard JA, van Holsbeeck MT. Wooden foreign bodies in soft tissue: detection at US. Radiology 1998;206:45-48 https://doi.org/10.1148/radiology.206.1.9423650
  10. Bray PW, Mahoney JL, Campbell JP. Sensitivity and specificity of ultrasound in the diagnosis of foreign bodies in the hand. J Hand Surg Am 1995;20:661-666 https://doi.org/10.1016/S0363-5023(05)80287-4
  11. Boyse TD, Fessell DP, Jacobson JA, Lin J, van Holsbeeck MT, Hayes CW. US of soft-tissue foreign bodies and associated complications with surgical correlation. Radiographics 2001;21:1251-1256 https://doi.org/10.1148/radiographics.21.5.g01se271251
  12. Malone DG, Clark TB, Wei N. Ultrasound-guided percutaneous injection, hydrodissection, and fenestration for carpal tunnel syndrome: description of a new technique. J Appl Res 2010;10:116-123

피인용 문헌

  1. Foreign Body-Related Extremity Trauma in Children: A Single-Center Experience vol.52, pp.5, 2015, https://doi.org/10.4103/ortho.ijortho_311_17
  2. Ultrasound-guided hydrodissection for removal of precariously sited contraceptive implants vol.44, pp.4, 2015, https://doi.org/10.1136/bmjsrh-2017-200034
  3. Diagnostic and therapeutic role of ultrasound in soft tissue foreign bodies and associated complications: a pictorial essay vol.1, pp.1, 2015, https://doi.org/10.1007/s42058-019-00003-4
  4. US-guided Localization and Removal of Soft-Tissue Foreign Bodies vol.40, pp.4, 2015, https://doi.org/10.1148/rg.2020200001