INTRODUCTION
Removal of foreign objects such as bits of broken glass or a piece of broken needle from the plantar surface of the foot can be challenging. It is common for the surgeon to end up with a larger than planned surgical incision in pursuit of the elusive foreign object. Despite a long surgical incision, the foreign object may not be found; frequently, the surgeon has to use an image intensifier during the procedure to help locate the foreign object. We describe a simple technique, which could be used for removal of radio-opaque foreign objects from the plantar surface of the foot.
TECHNIQUE
The patient is positioned supine with the foot at the end of the operating table. The foot is prepared and draped as usual. Under image intensifier guidance, three 20-gauge needles are inserted, 2 cm apart, angled at 45° to the plantar surface of the foot so that the tips of the needles are in contact with the radio-opaque foreign object. The needles are inserted around the puncture wound on the plantar surface of the foot. The skin is incised in the triangular region between the needles (Fig. 1). Sharp dissection carried down to the tips of the needles will identify the foreign object and facilitate easy removal.
Figure 1.
The surgical incision is through the centre of the triangular area formed by the needle insertion sites (circles)
CONCLUSION
This is a simple technique for identifying and removing radio-opaque foreign objects from the plantar aspect of the sole.