pinching feeling

A 48-year-old male patient presented to the emergency department within an hour of sustaining a crush injury to his foot at work. The patient told that a 21 ton metal object fell on his foot. He stated this remained on his foot for several minutes while awaiting the arrival of a forklift to remove the object. The patient admitted to wearing steel toe boots when this occurred. Despite the significant trauma sustained to his foot, his dorsalis pedis and posterior tibial pulses remained palpable. His light touch sensation was intact to his plantar forefoot. Compartment syndrome did not appear to be a complication in this scenario because of the open nature of his injury and the sparing of his midfoot and ankle from injury. Upon presentation to the emergency department, blood loss was minimal given the extent of the injury. There was no pulsatile bleeding. As visible in the photos, his skin had already begun to demarcate via ecchymosis and early necrosis. The patient sustained partial amputations of the second, third and fourth digits with multiple comminuted open fractures and after discussing all possible treatment options, agreed to proceed with a transmetatarsal amputation. He was also given prophylactic parenteral antibiotic and a tetanus shot. The patient stayed overnight in the hospital for observation and was discharged home the next day.

Points: 20
Mucho User glandmilker
by glandmilker
Submitted on Apr 16, 2018
Gross



Tags: toes foot crush smashed accident shoe Wile E coyote
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