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Plantar and Pedal Puncture Wounds in Children

A Case Series Study From a Single Level I Trauma Center

Volk, Angela MD*; Zebda, Mohamed MD; Abdelgawad, Amr A. MD

doi: 10.1097/PEC.0000000000000615
Original Articles

Objectives The purpose of this study was to describe our experience in treatment of pediatric patient presenting with pedal puncture wound to our level I trauma center and describe our results for the need for hospitalization and/or surgery for these patients.

Methods Children and adolescents 18 years and younger presenting with pedal puncture wounds from September 2009 to December of 2013 were retrospectively studied. Exclusion criteria included adult patients, wounds related to animal bites, lacerations associated with a motor vehicle collision or all-terrain vehicle accidents, gunshot wounds, degloving injuries, or injuries resulting in complex lacerations to the foot.

Results A total of 147 children presented to emergency department (ED) with a pedal puncture wound. Average age was 9.8 years. Prophylactic antibiotic therapy was administered in 107 cases (72.8%). Fifteen patients (10%) were treated with intravenous or intramuscular antibiotics in the ED or after hospital admission, 81 patients (55%) were treated with oral medications (prescribed for them to be taken after discharge), and 35 patients (24%) received topical antibiotic treatment. Of the 147 patients included in the study, 9 patients (6%) required the need for hospitalization. Two patients were admitted for parenteral antibiotic treatment only, and 7 patients required formal surgical debridement in the operating room in addition to parenteral antibiotic therapy.

Conclusions The majority of pediatric patients with pedal puncture wounds were treated in the ED with only a small percentage of patients requiring admission for either parenteral antibiotic treatment or formal surgical debridement.

From the *Paul L. Foster School of Medicine, and Departments of †Pediatrics and ‡Orthopedic Surgery, Paul L. Foster School of Medicine, Texas Tech University Health Science Center, El Paso, TX.

Disclosure: The authors declare no conflict of interest.

Study was performed in the Orthopedic Department of the Texas Tech University Health Science Center at El Paso, TX.

Reprints: Amr A. Abdelgawad, MD, Department of Orthopedic Surgery, Paul L. Foster School of Medicine, Texas Tech University Health Science Center, 4801 Alberta Ave, El Paso, TX 79905 (e-mail:

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