Hand Foreign Body-induced Osteomyelitis Due to Retained Wood for 12 Years: A Case Report

Penetrating injuries frequently result in retained foreign bodies, which are often overlooked during initial examination. Delayed detection can lead to complications such as infections, tissue reactions, and functional impairment. Early diagnosis and intervention are essential to optimizing patient outcomes. This report described a case of chronic osteomyelitis caused by a retained wooden foreign body in the hand, highlighting the challenges in diagnosis and management. A 42-year-old male laborer presented with a 12-year history of recurrent hand infections despite multiple treatments. Physical examination revealed a palpable mass, erythema, and a draining sinus tract. Magnetic resonance imaging demonstrated a 3-cm foreign body deep to the flexor tendons and superficial to the proximal third metacarpal, with associated osteomyelitis. Surgical removal of the foreign body and debridement of infected tissue were performed. The patient received a 6-week course of antibiotics, and his symptoms fully resolved. Postoperative follow-up was limited to a single visit at 4 months, which showed reduced swelling and erythema without any active pus discharge. The patient was then nonadherent with all further appointments for culture-directed therapy, infectious disease review, and rehabilitation, despite being discharged on a 6-week course of oral levofloxacin. This case underscored the importance of thorough history-taking, advanced imaging, and early surgical management in cases involving retained foreign bodies. By improving diagnostic strategies and emphasizing prevention, clinicians can enhance patient outcomes and reduce complications associated with foreign body injuries in the hand.