Case Report An Unusual Surgical Emergency" A Knee Joint Wound Caused by a Needlefish

Summary: The authors report the case of a knee joint wound caused by a needlefish of the Belonid type, or "Orphie." This observation is one of a series of 10 traumas reported over the past few years with this dangerous fish that resides in the New Caledonian lagoon. The authors show the importance of a thorough clinical examination of the patient and, more especially, the importance of the radiological opacity of the foreign body, which is essential for diagnosis. Our experience with this type of wound in articular disorders leads us to recommend arthroscopic treatment combined with intraoperative radiological control. This method is to assure the total exeresis of the foreign body whose sepsis would irremediably cause serious acute arthritis. Key Words: Needlefish wound--Articular wound--Arthroscopy. T he Great Reef that encircles New Caledonia in the South Pacific is the domain for sharks and several thousand species of fish. Over the past 6 years, we have had five nondebilitating shark bites and no deaths. Needlefish (or garfish) were responsible for twice as many serious accidents, especially among windsurfers, divers, and fisherman. This fish, with a long, thin body from 30 to 150 cm long, and a jaw formed by a long beak, can stream just above the surface of the water for several dozen yards like a torpedo. When the fish and man collide, a deep, penetrating injury is the usual result. We report an interesting case of a knee joint wound by a needlefish that was treated arthroscopically.