Watch your step when barefoot, because anything sharp -- from nails to snails -- can get stuck in your foot. Its one thing to get a simple puncture, but another to have the object become embedded (also known as a foreign body). Punctures and foreign bodies of the foot are serious. They can lead to limb- and life-threatening infections.
As a reconstructive foot surgeon, I have seen a variety of items get lodged in the foot, requiring surgery to remove them.
How Are Puncture Wounds and Foreign Bodies Treated?
It is important to have all puncture wounds evaluated by a medical professional. Timing is critical because infection can set in quickly. Of course, tetanus is huge concern with puncture wounds and doctors will investigate your immunity.
Most punctures tend to superficial. Deeper punctures are more serious, as they can immediately involve tendon, muscle and bone. Objects can be embedded through the smallest of wounds. Sometimes the puncture wound can barely be visible and have little to no bleeding. The most common item people step on is nails. Other items are glass, sewing needles and wood.
Some people step on sharp objects and don't even realize it until after the fact, and the foot becomes infected. This tends to occur in people with diabetes and weakened sensation (medically known as peripheral neuropathy).
Retained objects after pedal (foot) puncture occur in less than 10 percent of cases. X-rays can identify retained metallic items. Glass is typically invisible on x-rays unless its composition has some metallic elements. Ultrasound can be useful. Advanced imaging (MRI and CT) may be needed when x-rays don't show anything retained and there is high index of suspicion.
When Is Surgery Needed to Remove a Foreign Body?
Many punctures are treated in the emergency room or urgent care setting. Sometimes doctors immediately open the puncture site and "wash it out." Surgeons may perform a surgical debridement (cleaning) in the operating room when the puncture is more serious, infected and/or there is a foreign body retained. Antibiotics are an often necessary part of treatment, and of course determined by a health care professional.
Obviously nobody wants to step on something and have it stuck in their foot. But these things happen, and are more likely to occur when barefoot. Punctures to the foot are serious and should receive immediate medical evaluation and treatment.
Watch your step...
Dr. Neal Blitz
New York City
For more by Neal M. Blitz, D.P.M., F.A.C.F.A.S., click here.
For more on personal health, click here.