Wrong Foot Forward - A Rare Injury by Indian Tiffin Box

Although the penetrating injuries to the foot are common and sometimes they may be associated with calcaneum fracture, this case highlights a very rare injury by relatively harmless "Indian tiffin box."

A 30-year-old man was admitted to our hospital with a history of stepping over the Indian tiffin box. He presented with a tiffin box embedded in his right sole with food particles (pulses) inside the wound. It was associated with undisplaced, extra-articular fracture of calcaneus. Contamination with food particles and delayed presentation had added extra risk of infection. Aggressive management by wound lavage, debridement, and intravenous antibiotics has prevented the delayed complication like osteomyelitis.

Harmless-looking tiffin box can cause significant injury. Evaluation and proper management of soft-tissue involvement, especially heel pad, is very important due to its association to outcome. Proper documentation is equally important to avoid tricky medicolegal situations.