Presentation
A diabetic male had wood splinter penetrating injury to the leg about 6 weeks prior the presentation. He complained of local pain, swelling and discharge in spite of repeated local dressing.
Patient Data
There is an ill-defined soft tissue swelling involving the lateral-posterior side of the mid-third leg region. There are calcaneal plantar spur and Achilles enthesophyte.
There is an entry wound on the anterior-lateral side of the mid-third leg region. It leads to a collection with mobile echoes involving the muscles (extensor digitorum longus, peroneus longus, and part of the soleus) and posterior leg subcutaneous tissue. The linear echogenic focus (56 mm length) is a foreign body in the abscess cavity. The anterior tip of the foreign body is about 20 mm away from the entry wound. Its posterior tip lies in the subcutaneous plane. There is a buckle fracture of the foreign body involving its distal third. The superficial peroneal nerve is normal lying just superficial to the foreign body. There is no cortical erosion involving adjacent tibia and fibula.
Photo shows an extracted foreign body which is a wood splinter.
Case Discussion
The case shows a foreign body induced abscess in the soft tissue of the leg in an elderly diabetic patient. The foreign body was retrieved surgically.
Foreign body photo courtesy: Operating surgeon Dr. Sanjay Modi.