Could There Be a Foreign Body in the Foot?

[摘要] A 31-year-old man presented to our emergency department with a penetrating wound to the left foot. He had jumped barefoot from a slackline onto forest floor 3 days previously. This had caused a small (0.4 × 0.4 cm) plantar calcaneal wound. Wound exploration in local anaesthesia on the day of the accident was performed externally and included application of an antibiotic wound dressing. Due to an elevated CRP (100), fever, and pain, radiography was performed, yielding no evidence of a foreign body. Magnetic resonance imaging identified an abscess cavity measuring approximately 5 × 2 × 1 cm in the medial subcutaneous/plantar region. The indication was made for open revision and exploration with a wide incision. Abundant purulent secretion was removed, following which a clinical improvement was seen and the patient was discharged. At the follow-up visit 4 weeks later, renewed putrid discharge from the wound was seen. Although the patient complained of increasing pain, his CRP levels were not elevated. During anaother wound revision, a 5.5 × 1 × 1 cm piece of branch, which was surrounded by an abscess cavity, was removed from the periosteal region of the calcaneus. Postoperatively, the patient‘s condition improved immediately and he was free of infection and pain. Foreign bodies can be overlooked on morphological imaging and even at surgery; the smallest skin wound may mask foreign bodies and deep tissue damage. Therefore, penetrating injuries should be explored surgically in a low-threshold approach.

[学科分类] 医学（综合）