Citation

Reiner MM, Khoury WE, Mackel A, Ehredt DJ, Razzante MC. J. Foot Ankle Surg. 2017; 56(6): 1305-1311.

Affiliation

Assistant Professor, Department of Podiatric Surgery, California School of Podiatric Medicine, Oakland, CA.

Copyright

(Copyright © 2017, Elsevier Publishing)

DOI

10.1053/j.jfas.2017.05.014

PMID

28807380

Abstract

Reports of ballistic injures to the extremities typically include those involving gunshot wounds. However, high-pressure washer injuries frequently lead to equally damaging injuries. These injuries should not be overlooked, because they can result in high morbidity and complication rates. Similar to the open fracture protocol, these injuries require prompt debridement and irrigation with administration of antibiotics to avoid limb loss. The present case report identified a delay in the treatment protocol that left limited options for the patient. However, the patient agreed to undergo staged reconstruction consisting of serial debridement, implantation of a polymethylmethacrylate antibiotic spacer, and eventual interpositional iliac crest arthrodesis of the midfoot. At a follow-up point >5 years from the initial injury, the patient was walking with minimal pain and no limitations in his daily activities.

Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Language: en

Keywords

iliac crest interpositional arthrodesis; injection injury; osteomyelitis tarsometatarsal joint; power washer; reconstruction of tarsometatarsal joint