Penetrating foot injuries are associated with a significant risk of retained foreign bodies, infection, and damage to osseous or soft tissue structures. Imaging is routinely recommended to assess the depth of penetration and exclude bone involvement. We report a case of a penetrating foot injury caused by a metallic wood screw that penetrated the sole of the shoe and the plantar aspect of the foot. Clinical assessment by an orthopedic specialist and radiographic imaging revealed no evidence of osseous injury. The foreign body was removed under local anesthesia with intravenous analgesia using a controlled rotational technique, followed by empirical antibiotic therapy and tetanus prophylaxis. Post-procedural imaging confirmed complete removal of the foreign body. No immediate complications were observed in the emergency department, and the patient was discharged with an urgent referral for outpatient orthopedic follow-up. This case highlights the importance of combining careful clinical examination with appropriate imaging in the emergency department management of penetrating foot injuries to guide safe foreign body removal and reduce the risk of complications.
Stanislaw Szymkiewicz (2026) studied this question.