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To the Editor: Long-standing peripheral neuropathy often compromises the normal protective mechanisms of pain in the affected extremities. In addition to chronic ulceration, acute injury due to foreign bodies also may occur. Broken fragments of insulin needles may "silently" penetrate the soft tissues, acting as a constant source of infection and reinjury. While the risk of such "silent needle" penetration seems apparent, only a single case of this complication has been reported previously.¹

Report of Cases

From 1988 to 1999 we evaluated 6 patients with insulin-dependent diabetes with sensory neuropathy and needle fragments in soft tissues. The patients were aged 47 to 75 years, 5 were women, and 5 were African American. Four patients had needle fragments in the soft tissues of their feet, 1 patient had a fragment in the abdominal wall, and 1 with coincidental syringomyelia had a fragment in the shoulder. Two patients had severe proximal muscle weakness, and 3 . . . [Full Text of this Article]

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