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Calcaneal osteomyelitis caused by nail puncture wounds
R T Laughlin1, F Reeve, D G Wright
1Wright State University, Department of Orthopedic Surgery, Dayton, Ohio 45440, USA.
Foot & Ankle International
|October 6, 1997
Summary
Nail puncture wounds can lead to calcaneus osteomyelitis. Diabetic patients with neuropathy face higher risks of multiple infections and amputation following such foot injuries.
Area of Science:
- Orthopedics
- Infectious Diseases
- Podiatry
Background:
- Plantar puncture wounds are common foot injuries.
- A small percentage (1.8%) of these wounds develop into osteomyelitis.
- Osteomyelitis of the calcaneus can result from puncture wounds, particularly those caused by nails.
Observation:
- This study reports on six patients who developed calcaneal osteomyelitis after a nail puncture wound to the heel.
- Patient characteristics, causative organisms, and outcomes were analyzed.
- Four patients were healthy, while two had diabetes mellitus.
Findings:
- Healthy patients typically had a single pathogenic organism cultured.
- Patients with systemic illness (diabetes mellitus) showed multiple pathogenic organisms.
- The only amputation occurred in a diabetic patient, indicating a poorer prognosis.
Implications:
- Diabetic patients with calcaneal osteomyelitis from nail punctures are prone to polymicrobial infections.
- The presence of diabetic neuropathy exacerbates the risk, potentially leading to chronic ulceration and increased amputation rates.
- Early recognition and management are crucial for preventing severe outcomes in diabetic individuals with puncture wound-related osteomyelitis.
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