Empty toe: a unique type of closed degloving injury with dismal outcome.
Closed degloving injury is characterized by the development of soft tissue separated from underlying structure without outer skin disruption. “Empty toe” is one of the most unique types of closed degloving injuries. Only 4 such injuries have been reported previously. We demonstrate a case of this entity in a 20-year-old scooter passenger. She presented to our emergency department with apparent deformity of the left fifth toe with intact skin. Radiographic examination showed no skeletal fracture or dislocation, but the skin of the injured toe was detached from the underlying bony structure. Despite repositioning the phalangeal bone into the empty toe, the skin was nonviable, and surgical site gangrene developed thereafter. The fifth toe was eventually amputated. An empty toe implies that the injured site has experienced severe compressive and shearing force with potential neurovascular damage. Health care providers should be fully aware of the high risk of the probability of vascular insufficiency, and the viability would be associated with vascular capability.
Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
Chen-Ling
CL
Tang
Su-Shin
SS
Lee
Tsung-Ying
TY
Lin
Yen-Ko
YK
Lin
Yung-Sung
YS
Yeh
Hsing-Lin
HL
Lin
Wei-Che
WC
Lee
Chao-Wen
CW
Chen
D000063:Accidents, Traffic; D000671:Amputation, Surgical; D005260:Female; D006801:Humans; D017695:Soft Tissue Injuries / Q000601:surgery*; D014034:Toes / Q000293:injuries* / Q000601:surgery*; D055815:Young Adult