Arthroscopic removal of improvised explosive device (IED) debris from the wrist: a case report

We present a case in which arthroscopy was used to remove foreign body debris secondary to an improvised explosive device (IED) from the wrist. The patient had noted pain for 6 months after sustaining multiple injuries after an IED detonation near the armored car in which he was traveling. He had pain on examination at the ulnar fovea with palpation and palpable clunking with forced ulnar deviation. Radiographs showed multiple small metallic objects scattered throughout the soft tissues, with one larger intra-articular object in the wrist. Metallic objects in joints can cause lead toxicity, chondral injury, and inflammatory reaction or abscess. Minimally invasive surgical treatment was proposed with the goals of further joint evaluation and excision of the metallic debris. Arthroscopic removal of the foreign body and repair of the triangular fibrocartilage complex resolved the patient's symptoms, and he had improved function at final follow-up at 22 months.