A 30 year-old builder presented with a 5-month history of pain in the left hand, after an injury in which a piece of ragged metal lacerated the base of the left thumb. Although the laceration healed fully without medical intervention, he continued to have pain at the base of the thumb during heavy lifting and forceful gripping. On examination, there was an obviously thickened and tender area deep in the palmar skin of the first web space. The pain was reproduced by pressure on this area and made worse by resisted thumb motion. Radiographs showed a small metallic foreign body within this region (Fig 1).
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