Tissue Injury

wounds is unknown, but with more than 5 million estimated lacerations repaired in EDs in 2007, wound FBs surely occur in such a significant number that all emergency physicians (EPs) will encounter them. Wound FBs are frequently missed on initial evaluation. Seventy-five of 200 FBs encountered in a hand clinic were missed by the initial physician. Furthermore, missed FBs pose high medicolegal risk for EPs, with one report listing it to be among the top three causes of litigation after wound care. Most wound FBs are wood, glass, or metal. The upper extremity is the most common location (58%), followed by the lower extremity (36%). The head and neck (4%) and the trunk (1%) are far less common. Most cases will be seen on the day of injury (75%), but some (8.7%) will initially be evaluated weeks, months, or years later.