Reconstruction After Osteomyelitis of the Midfoot From High-Pressure Washer Injury.

Abstract

Reports of ballistic injures to the extremities typically include those involving gunshot wounds. However, high-pressure washer injuries frequently lead to equally damaging injuries. These injuries should not be overlooked, because they can result in high morbidity and complication rates. Similar to the open fracture protocol, these injuries require prompt debridement and irrigation with administration of antibiotics to avoid limb loss. The present case report identified a delay in the treatment protocol that left limited options for the patient. However, the patient agreed to undergo staged reconstruction consisting of serial debridement, implantation of a polymethylmethacrylate antibiotic spacer, and eventual interpositional iliac crest arthrodesis of the midfoot. At a follow-up point >5 years from the initial injury, the patient was walking with minimal pain and no limitations in his daily activities.