Trench foot: Difference between revisions
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==Background== | ==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 | *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 | ||
Revision as of 14:44, 25 August 2015
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
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 joint 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