Skip to main content
PMC home page
The Western Journal of Medicine logoLink to The Western Journal of Medicine
. 1989 May;150(5):545–547.

Wound site as a predictor of complications following deep nail punctures to the foot.

M J Patzakis, J Wilkins, W W Brien, V S Carter
PMCID: PMC1026657  PMID: 2568034

Abstract

The site of injury, condition of the nail, and type of foot covering were compared in 36 inpatients and 34 outpatients with nail puncture wounds to the foot. Of the 36 inpatients, 34 (94%) had pyarthrosis, osteomyelitis, or both. The plantar surface of the foot was divided into 3 zones. Of the 36 inpatients, 35 (97%) had deep puncture wounds in zone 1. In contrast, only 6 of 34 (18%) outpatients had injury to this area. Tennis shoes were shown to predispose to infection with Pseudomonas aeruginosa. Based on our findings, an early hospital admission should be considered for all patients with deep puncture wounds located in zone 1 and for patients who give a history of bone penetration in zone 2 or 3 at the time of injury. All patients who meet the above criteria and who are not admitted to hospital should be observed closely.

Full text

PDF
545

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brand R. A., Black H. Pseudomonas osteomyelitis following puncture wounds in children. J Bone Joint Surg Am. 1974 Dec;56(8):1637–1642. [PubMed] [Google Scholar]
  2. Chusid M. J., Jacobs W. M., Sty J. R. Pseudomonas arthritis following puncture wounds of the foot. J Pediatr. 1979 Mar;94(3):429–431. doi: 10.1016/s0022-3476(79)80592-2. [DOI] [PubMed] [Google Scholar]
  3. Crosby L. A., Powell D. A. The potential value of the sedimentation rate in monitoring treatment outcome in puncture-wound-related Pseudomonas osteomyelitis. Clin Orthop Relat Res. 1984 Sep;(188):168–172. [PubMed] [Google Scholar]
  4. Feigin R. D., McAlister W. H., Joaquin V. H., Middelkamp J. N. Osteomyelitis of the calcaneus. Report of eight cases. Am J Dis Child. 1970 Jan;119(1):61–65. doi: 10.1001/archpedi.1970.02100050063014. [DOI] [PubMed] [Google Scholar]
  5. Fisher M. C., Goldsmith J. F., Gilligan P. H. Sneakers as a source of Pseudomonas aeruginosa in children with osteomyelitis following puncture wounds. J Pediatr. 1985 Apr;106(4):607–609. doi: 10.1016/s0022-3476(85)80082-2. [DOI] [PubMed] [Google Scholar]
  6. Fitzgerald R. H., Jr, Cowan J. D. Puncture wounds of the foot. Orthop Clin North Am. 1975 Oct;6(4):965–972. [PubMed] [Google Scholar]
  7. Fritz R. H., Crosson F. J. Concerning the source of pseudomonas osteomyelitis of the foot. J Pediatr. 1977 Jul;91(1):161–162. doi: 10.1016/s0022-3476(77)80477-0. [DOI] [PubMed] [Google Scholar]
  8. Glober G. A., Wilkerson J. A. Biliary cirrhosis following the administration of methyltestosterone. JAMA. 1968 Apr 8;204(2):170–173. [PubMed] [Google Scholar]
  9. Goldstein E. J., Ahonkhai V. I., Cristofaro R. L., Pringle G. F., Sierra M. F. Source of Pseudomonas in osteomyelitis of heels. J Clin Microbiol. 1980 Nov;12(5):711–713. doi: 10.1128/jcm.12.5.711-713.1980. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. HOUSTON A. N., ROY W. A., FAUST R. A., EWIN D. M. Tetanus prophylaxis in the treatment of puncture wounds of patients in the deep South. J Trauma. 1962 Sep;2:439–450. doi: 10.1097/00005373-196209000-00002. [DOI] [PubMed] [Google Scholar]
  11. Hagler D. J. Pseudomonas osteomyelitis: puncture wounds of the feet. Pediatrics. 1971 Oct;48(4):672–673. [PubMed] [Google Scholar]
  12. Higham M. Infection in a puncture wound after it 'healed'. Hosp Pract (Off Ed) 1983 Apr;18(4):47–54. doi: 10.1080/21548331.1983.11702512. [DOI] [PubMed] [Google Scholar]
  13. Jacobs R. F., Adelman L., Sack C. M., Wilson C. B. Management of Pseudomonas osteochondritis complicating puncture wounds of the foot. Pediatrics. 1982 Apr;69(4):432–435. [PubMed] [Google Scholar]
  14. Janda J. M., Bottone E. J. Pseudomonas aeruginosa enzyme profiling: predictor of potential invasiveness and use as an epidemiological tool. J Clin Microbiol. 1981 Jul;14(1):55–60. doi: 10.1128/jcm.14.1.55-60.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Lang A. G., Peterson H. A. Osteomyelitis following puncture wounds of the foot in children. J Trauma. 1976 Dec;16(12):993–999. doi: 10.1097/00005373-197612000-00010. [DOI] [PubMed] [Google Scholar]
  16. Lynch M. C., Dorgan J. C. A case of Pseudomonas aeruginosa osteomyelitis of the tarsal cuboid following a penetrating wound of the foot in childhood. Injury. 1983 Jan;14(4):354–356. doi: 10.1016/0020-1383(83)90256-5. [DOI] [PubMed] [Google Scholar]
  17. MacKinnon A. E. Pseudomonas osteomyelitis following puncture wounds. Postgrad Med J. 1975 Jan;51(591):33–34. doi: 10.1136/pgmj.51.591.33. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Miller E. H., Semian D. W. Gram-negative osteomyelitis following puncture wounds of the foot. J Bone Joint Surg Am. 1975 Jun;57(4):535–537. [PubMed] [Google Scholar]
  19. Minnefor A. B., Olson M. I., Carver D. H. Pseudomonas osteomyelitis following puncture wounds of the foot. Pediatrics. 1971 Mar;47(3):598–601. [PubMed] [Google Scholar]
  20. Riegler H. F., Routson G. W. Complications of deep puncture wounds of the foot. J Trauma. 1979 Jan;19(1):18–22. doi: 10.1097/00005373-197901000-00004. [DOI] [PubMed] [Google Scholar]
  21. Siebert W. T., Dewan S., Williams T. W., Jr Case report. Pseudomonas puncture wound osteomyelitis in adults. Am J Med Sci. 1982 Mar-Apr;283(2):83–88. doi: 10.1097/00000441-198203000-00006. [DOI] [PubMed] [Google Scholar]

Articles from Western Journal of Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES