Orthopaedic Manifestations of Date Thorn Injury: Case series

Abstract

Date palm thorn injuries are common in Middle Eastern countries where there are many date palm plantations. Most of the injuries happen to workers in the plantation or to children. Injuries, if detected, can be treated without subsequent complications, but in children the diagnosis can very easily be missed resulting in late complications. The hand, being the most exposed part of the body, is the most affected. Embedded thorns can produce lesions mimicking those of osteomyelitis. The foot is exposed to injuries in people who walk barefoot in the plantations. The author presents five cases of date thorn injury which presented with late complications. All three patients with hand injuries had periostitis, and one of them had an intraosseous thorn producing osteomyelitis. Two patients presented with osteolytic lesions of the metatarsals with intraosseous thorn in one patient. All cases recovered completely leaving behind no sequlae of the bony infection.

Keywords: Bone cyst; Case Report; Foreign body granuloma; Hand; Metatarsal; Oman; Osteomyelitis; Periostitis.

Figure 1:. Ultrasound scan. FB 11 mm lying 5 mm deep to skin, granuloma measuring 24 x 7.6 mm around the thorn

Figure 2:. X-ray of foot showing osteomyelitis of 2nd metatarsal

Figure 3:. CT scan of the right foot showing lytic lesion (arrow)

Figure 4:. Date thorn infection of 3rd metacarpal. Single arrow: lytic lesion base of metacarpal; double arrow: periosteal reaction

Figure 5:. Periosteal reaction of the middle phalanx of right middle finger