Pitfalls in diagnosis and problems in extraction of retained wooden foreign bodies in the foot.

The detection and removal of a radiolucent foreign body in soft tissues is a problem. It is further complicated when it is not radio-opaque and embedded in the deep layers of the foot. Despite advances in imaging techniques, the detection of retained wooden foreign bodies remains a difficult and challenging task. Although radiographs have been proven to be ineffective, it is often the first method used. Wood often splinters, causing incomplete removal and persistent symptoms. In such cases complete surgical extraction cannot be guaranteed in spite of our best efforts. Therefore, a post-procedure imaging to ensure the adequacy of extraction becomes crucial. The choice of imaging in such circumstances is a moot point to consider. This case report highlights the common pitfalls associated with retained wooden foreign bodies and demonstrates how ultrasonography could be used as a simple and effective tool in this regard. Copyright 2009 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.