beware of a nail prick injury with a rubber sole shoe wear
TRANSCRIPT
Beware of a nail prick injury with a rubber sole shoe wear
APME-294; No. of Pages 2
Beware of a nail prick injury with a rubber sole shoewear
Vikram Khanna a,*, Raju Vaishya b, Ishan Ghuse a, Nilesh Virani a
aDepartment of Orthopaedics, National Institute of Medical Sciences, Jaipur, IndiabDepartment of Orthopaedics, Indraprastha Apollo Hospital, New Delhi, India
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a r t i c l e i n f o
Article history:
Received 9 May 2015
Accepted 28 May 2015
Available online xxx
Available online at www.sciencedirect.com
ScienceDirect
journal homepage: www.elsevier.com/locate/apme
Fig. 1 – Clinical picture showing healed scar at the plantaraspect of foot after a nail injury.
Walking around barefoot in the grass can be relaxing and somuch fun but stepping on a nail can take the fun out ofbarefoot walking. Contrary to the popular belief, it is observedthat it is better to step on a nail barefooted rather than withwearing shoes or flip flops. This is because whenever a personsteps on a nail wearing a shoe, then the sharp nail end takes asmall part of the rubber sole through the skin and deposits itbelow the skin.1 This may become a cause for persistentinfection and might leave the treating doctor at a loss to findout the cause of the persistent infection or an abscess.Retained foreign bodies including thorn,2 wooden splinters,3
metallic nail, etc. must be considered in cases with persistentinfection of the foot, and a prompt removal of such an objectleads to its swift cure.
A 22-year-old male patient came to us with a history ofstepping on a nail one month ago. The retained nail wasremoved under local anaesthesia, and with regular dressings,the wound on the plantar surface had healed (Fig. 1). 3 weeksafter this incident, he presented again with a small, localisedswelling over the dorsal surface at the base of the 4th toe.Clinically, it was thought to be an antibioma. Plain radiographof the foot did not reveal any foreign body or evidence ofosteomyelitis. But an ultrasonography of the foot raised asuspicion of a foreign body or a subcutaneous neuroma. Anexploration of this swelling was done under local anaesthesia.
* Corresponding author at: Department of Orthopaedics, NIMS MedicaE-mail address: [email protected] (V. Khanna).
Please cite this article in press as: Khanna V, et al. Beware of a nail pridoi.org/10.1016/j.apme.2015.05.017
http://dx.doi.org/10.1016/j.apme.2015.05.0170976-0016/# 2015 Indraprastha Medical Corporation Ltd. Published by
Thick creamy pus along with a piece of rubber (Figs. 2 and 3)was extracted from the cavity. The pus grew Staphylococcusaureus. The patient responded to antibiotics and the woundhealed by secondary intention by 10 days.
l College, Jaipur, India. Tel.: +91 7073647974.
ck injury with a rubber sole shoe wear, Apollo Med. (2015), http://dx.
Elsevier B.V. All rights reserved.
Fig. 2 – Intra operative picture showing an incision given atthe base of the 4th toe.
Fig. 3 – Piece of rubber sole removed from the abscesscavity.
a p o l l o m e d i c i n e x x x ( 2 0 1 5 ) x x x – x x x2
APME-294; No. of Pages 2
Please cite this article in press as: Khanna V, et al. Beware of a nail pridoi.org/10.1016/j.apme.2015.05.017
1. Learning points/take home message
� Awareness about the foreign body prick injuries is importantin patients with persistent or recurrent infections.
� In nail prick injuries of the foot, the possibility of presence ofrubber remnants from the footwear sole should be kept inmind.
Conflicts of interest
The authors have none to declare.
r e f e r e n c e s
1. Tietz R. ER doctor. May 2012; http://doctordude.blogs.petaluma360.com/10911/stepped-on-a-nail.
2. Vaishya R. ‘‘A thorny problem’’: diagnosis & treatment ofacacia thorn injuries. Injury. 1990;21:97–100.
3. Middha VP, Vaishya R. Wooden lesions produced bysplinters of wood in soft tissues & bone. Int Orthop (SICOT).1990;14:47–48.
ck injury with a rubber sole shoe wear, Apollo Med. (2015), http://dx.
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