GWOT Lessons Learned: Metal in Africa

Area of Science:

• Orthopedic Surgery
• Diagnostic Imaging
• Military Medicine

Background:

• Intra-articular metallic foreign bodies pose risks including limited range of motion and plumbism.
• Identifying retained metallic objects can be difficult with physical examination alone due to unpredictable trajectories.
• Ultrasound offers a valuable tool for foreign body localization, particularly in resource-limited environments.

Purpose of the Study:

• To highlight the challenges and successful management of an intra-articular metallic foreign body in a deployed Special Operations Forces Operator.
• To emphasize the utility of ultrasound in identifying retained intra-articular metallic foreign bodies.
• To advocate for the prompt removal of intra-articular metallic foreign bodies to ensure optimal patient outcomes.

Main Methods:

• Case report of a Special Operations Forces Operator with a retained intra-articular metallic foreign body during a deployment.
• Utilized ultrasound for the identification and localization of the metallic foreign body.
• Surgical consultation and subsequent removal of the foreign body.

Main Results:

• Successful identification and removal of the intra-articular metallic foreign body.
• Preservation of the operator's range of motion post-removal.
• Facilitation of the operator's return to duty in the deployed location.

Conclusions:

• Prompt removal of intra-articular metallic foreign bodies is crucial for preventing long-term complications.
• Ultrasound is an effective imaging modality for locating metallic foreign bodies in joints, especially in austere environments.
• Effective management strategies can lead to favorable outcomes, including return to full duty.