Empty Toe Phenomenon: A Rare Presentation of Closed Degloving Injury of the Foot.
Traumatic degloving injuries of the lower extremity are commonly diagnosed by soft tissue deficits and separation of soft tissue planes. The management of open degloving injuries is well documented with established treatment protocols. Because closed degloving injuries of the lower extremity are so rare, the protocol management is not well established. Unlike open degloving injuries, evidence of soft tissue injury and detachment of the tissue planes can be subtle. Owing to the rarity of these injuries, little has been described regarding the long-term outcomes. In the present report, 2 closed degloving cases are presented. The first case presented is of a 27-year-old railroad worker who sustained a severe closed degloving injury of his foot with digital soft tissue envelope transposition. The second case involved a 60-year-old automobile manufacturer, whose foot was crushed by a hydraulic fork lift, creating a degloving injury of the third, fourth, and fifth toes. The follow-up duration from the date of injury for patient 1 was 26 months and for patients 2 was 16 months. The purpose of presenting these cases is to report these rare injuries with the treatment, complications, and outcomes.
Foot and Ankle Specialty Clinic, Russellville, AR.
Adam L
AL
Bingham
Diplomate, America Board of Podiatric Surgery, Director, Podiatric Surgical Residency, Beaumont Hospital-Wayne, Wayne, MI. Electronic address: lfallatdpm@aol.com.
Lawrence M
LM
Fallat
D000328:Adult; D000671:Amputation, Surgical / Q000379:methods*; D000071576:Crush Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D000069836:Degloving Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D018409:Foot Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery; D011859:Radiography / Q000379:methods; D012086:Reoperation / Q000379:methods; D018570:Risk Assessment; D012494:Sampling Studies; D014034:Toes / Q000000981:diagnostic imaging / Q000293:injuries; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
Morel-Lavallée injury; compartment syndrome; crush injury; empty toe; trauma