Cases reported "Immersion Foot"

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1/4. Trench foot following a collapse: assessment of the feet is essential in the elderly.

    Elderly patients commonly present to hospital following a collapse and period of distressing immobilisation on the floor. We present a case of bilateral trench foot in such a patient with no prior peripheral vascular disease. Examination of the feet is mandatory for early detection of this rare condition in the collapsed elderly patient.
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keywords = trench
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2/4. Recent cases of trench foot.

    Two cases of cold injury to the lower extremities, 'trench foot', are presented. The management is essentially conservative, but in cases of severe damage, particularly in elderly people, amputation must be advised.
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ranking = 5
keywords = trench
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3/4. A case of bilateral trench foot.

    A case of severe bilateral trench foot is presented in a patient who lived rough for 3 weeks without removing his boots. Non-operative management yielded no clinical improvement and bilateral below-knee amputation was necessary. histology revealed subcutaneous and muscle necrosis with secondary arterial thrombosis.
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ranking = 5
keywords = trench
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4/4. Neuropathy in non-freezing cold injury (trench foot).

    Non-freezing cold injury (trench foot) is characterized, in severe cases, by peripheral nerve damage and tissue necrosis. Controversy exists regarding the susceptibility of nerve fibre populations to injury as well as the mechanism of injury. Clinical and histological studies (n = 2) were conducted in a 40-year-old man with severe non-freezing cold injury in both feet. Clinical sensory tests, including two-point discrimination and pressure, vibration and thermal thresholds, indicated damage to large and small diameter nerves. On immunohistochemical assessment, terminal cutaneous nerve fibres within the plantar skin stained much less than in a normal control whereas staining to von willebrand factor pointed to increased vascularity in all areas. The results indicate that all nerve populations (myelinated and unmyelinated) were damaged, possibly in a cycle of ischaemia and reperfusion.
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ranking = 5
keywords = trench
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