Difference between revisions of "Trench foot"
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*Develops slowly over hours-days when foot is exposed to cold/wet conditions | *Develops slowly over hours-days when foot is exposed to cold/wet conditions | ||
*Reversible injury may progress to irreversible injury | *Reversible injury may progress to irreversible injury | ||
| + | *rarely seen in civilians; significant problem in military operations <ref>Ikaheimo T. Frostbite and Other Localized Cold Injuries. In: Tintinalli's Emergency Medicine: A comprehensive study guide. 7th ed. McGraw Hill Medical; 2011: 1331</ref> | ||
==Clinical Features== | ==Clinical Features== | ||
Revision as of 14:59, 25 August 2015
Contents
Background
- Considered a nonfreezing cold injury
- occurs when ambient temperature above freezing
- Develops slowly over hours-days when foot is exposed to cold/wet conditions
- Reversible injury may progress to irreversible injury
- rarely seen in civilians; significant problem in military operations [1]
Clinical Features
- Tingling/numbness is initial symptom
- Foot appears pale, mottled, anesthetic, pulseless, and immobile
- Initially does not change after rewarming
- Hyperemic phase begins w/in hr after rewarming
- Assoc w/ severe burning pain and reappearance of proximal sensation
- As perfusion returns to foot over 2-3d edema and possibly bullae may form
- Anesthesia persists for weeks and may be permanent; gangrene may occur
Differential Diagnosis
Foot diagnoses
Acute
- Foot and toe fractures
- Subtalar dislocation
- Metatarsophalangeal sprain (turf toe)
- Acute arterial ischemia
- Calcaneal bursitis
Subacute/Chronic
- Diabetic foot infection
- Peripheral artery disease
- Plantar fasciitis
- Trench foot
- Ingrown toenail
- Paronychia
- Tinea pedis
- Morton's neuroma
- Diabetic neuropathy
Cold injuries
- Generalized
- Freezing
- Non-freezing
Diagnosis
- Usually clinical
Treatment
- Keep feet clean, warm, dryly bandaged, elevated
- Monitor for signs of infection
See Also
References
- ↑ Ikaheimo T. Frostbite and Other Localized Cold Injuries. In: Tintinalli's Emergency Medicine: A comprehensive study guide. 7th ed. McGraw Hill Medical; 2011: 1331