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Pseudomonas osteomyelitis of the metatarsal sesamoid bones
1Fort Wayne Orthopaedics, Indiana, USA.
Abstract:
It is unusual for osteomyelitis of the sesamoid bones to occur after a puncture wound to the foot. When the puncture occurs through tennis shoes, the risk of Pseudomonas infection is increased. Pseudomonas was the causative organism in 7 of 22 cases reported in the literature. This report will explore the causes and natural history, as well as the treatment, of these infections. Initially, basic wound care principles should be adhered to when treating these wounds. Patient awareness and close follow-up is important to ensure complete healing. Treatment of this case involved intravenous antibiotics and medial sesamoidectomy. Foot deformities can occur with sesamoid osteomyelitis and sesamoid excision. Hallux valgus deformity was noted to occur with the osteomyelitis and worsen with sesamoid excision. Preservation of surrounding structures during excision is important to prevent deformity.
Insights
Osteomyelitis of the sesamoid bones is rare following foot puncture wounds, especially those from tennis shoes, increasing Pseudomonas infection risk. Early wound care and close follow-up are crucial for healing, with surgical intervention potentially causing foot deformities.
Area of Science:
- Orthopedics
- Infectious Diseases
- Podiatry
Background:
- Osteomyelitis of the sesamoid bones is an uncommon condition.
- Puncture wounds to the foot, particularly through athletic footwear, present a risk for infection.
- Pseudomonas species are a significant concern in such infections.
Observation:
- A case of sesamoid osteomyelitis following a foot puncture wound is presented.
- The causative organism was identified, highlighting the risk of Pseudomonas infection.
- The patient underwent treatment involving intravenous antibiotics and medial sesamoidectomy.
Findings:
- Sesamoid osteomyelitis can lead to foot deformities, including hallux valgus.
- Surgical excision of the sesamoid bone can exacerbate existing deformities.
- Preserving surrounding structures during surgical intervention is vital.
Implications:
- This case underscores the importance of prompt and appropriate wound care for puncture injuries.
- Close patient monitoring is essential to prevent complications and ensure complete healing.
- Surgical techniques should prioritize the preservation of anatomical structures to minimize post-operative deformities.
