Crush injuries to the foot can be very serious injuries.

Sometimes these injuries are medical emergencies.

There are serious long term side effects that can happen if these injuries are not treated quickly and correctly.

Crush injuries occur when the foot or leg becomes trapped under a heavy object.

The foot is made of different compartments which contain bones, muscles, tendons, nerves, and blood vessels. All of these structures are affected with crush injuries.

With a crush injury the pressure in these compartments can greatly increases. As a result, there is less blood flow in and out of the compartments. When the structures in compartments do not receive enough blood, there is the risk that they will start to die. This is called a compartment syndrome. Not all crush injuries get a compartment syndrome. But it is a serious complication

Symptoms of crush injuries and increased pressure in foot and leg compartments are extreme pain and swelling to the area. The skin might become numb and the muscles might be weak from the pressure. Your doctor may have to measure the pressure in the foot compartments to be sure of the diagnosis. There are special instruments that the doctor would use to do this.

Treatment of crush injuries involves immobilizing and protecting the injuried part. This is usually with a splint, cast or boot. Additional evaluation with a CT or MRI is often needed.

With a compartment syndrome, then releasing pressure in compartments, which is done with an operation, is necessary. The skin over the compartment is cut open and left open for several days, until the swelling goes down. Unhealthy tissue will be removed during surgery. If needed, skin grafts are used at a later date.

If there are broken bones, these are fixed during surgery. Your doctor might use screws, plates, or pins to hold the pieces of bone together. Using these will keep the bones in place and result in better healing.

With these injuries it is important to go to the emergency room or call us right away. A Podiatric Physician and surgeon needs to begin treatment as soon as possible for the best results.

Additional evaluation and treatment is sometimes needed after healing occurs. The goal is to protect to foot and have the foot function as well as possible.
 

Puncture wounds of the foot are a common and aggravating injury.

Puncture injuries happen when a (usually unprotected) foot steps on an object and that object cuts through the skin and into the foot.

The object usually has a sharp or pointed end, like a piece of glass or a nail. The bottom of the foot is the area most commonly affected.

These wounds can have serious complication such as infection.

The puncture, and an infection, can go all the way to the bone.

Therefore, is important to see your Podiatric Physician, or go to the emergency room after experiencing a puncture wound in the foot.

Most textbooks now recommend that the wound be seen and treated within the first 24 hours. This is because the object and the surfaces are dirty and can cause serious infection. We want to treat the wound quickly – before infection sets in.

Infections in the bottom of the foot are not to be taken lightly as they can quickly spread.

The object that was stepped on may become stuck in the foot as well. This is called a foreign body. If this is the case, then quick removal is even more important. The longer the object is in the foot, the greater the chance of infection.

We see splinters, toothpicks, glass, sewing needles as well as nails, plastic shards and even human and animal hairs entering feet.

Wearing shoes and socks is good protection but can complicate a wound, as shoes and socks are also dirty and harbor bacteria. Pieces of the shoe or sock can also be forced into the foot with the puncture.

For people with diabetes, it is even more crucial to be treated by a Podiatric Physician quickly. Many patients with diabetes have numbness in their feet, so it is possible to step on a nail or other object and not have it hurt much.

Also, some Diabetics do not fight infection well and must have antibiotics – the sooner the better.

Signs of infection to look for include pain, swelling, inability to walk, redness, pus or bloody drainage. This could lead to fever, chills, nausea, and vomiting. It may take a couple of days to see these signs, so it is better to get treatment early.

Your Podiatric Physician examines the puncture wound and determines how deep it goes. Dirt and objects are removed. The wound is well cleaned.

X rays are often taken to help locate objects (foreign body) and check the bone.

Sometimes in office ultrasound is utilized. Occasionally even an MRI is needed.

Antibiotics are prescribed.

Tetanus booster is needed if it has been years since your last tetanus shot.

We at Middle Tennessee Foot Associates have two offices and three Doctors available to treat these injuries.

We can most always get you into the office to see a Podiatric Physician the day you are hurt or the day you call.

Call us at 1-931-728-3988 if you have a question or need to be seen.