Finger pulp infections commonly occur due to bacteria entering through wounds. Foreign body-related pulp infections are uncommon and can present atypically. In this rare case, infection occurred due to a retained cement bead, which was surgically implanted for treating a compound, comminuted distal phalanx fracture with bone loss. A 22-year-old woman presented with persistent swelling, dull pain, and discharge from the pulp of the right middle finger for three months, unresponsive to empirical antibiotic therapy. Examination revealed localized swelling, tenderness with a puncture wound, and pus discharge from the tip of the right middle finger. The patient gave a history of surgical treatment for a compound fracture of the distal phalanx of the middle finger eight years back with cement bead insertion. X-ray showed a radiopaque oblong shadow embedded in the distal phalanx remnant fragment. Surgical exploration revealed an oblong-shaped cement bead encapsulated within granulation tissue. Removal of this cement bead and drainage resulted in rapid symptom resolution. Retained antibiotic cement beads may cause atypical pulp infections with subtle presentations. It is absolutely necessary to ensure patient follow-up and make the patient understand the need for cement bead removal at the appropriate time to prevent complications.
Sonegaonkar et al. (2026) studied this question.