A rare case of closed degloving injury of the fifth toe

Abstract

Empty toe injury is a rare type of closed degloving injury; limited cases have been reported previously, with controversial outcomes. Our case is a 22 year old male who was injured by a trolley bus. The patient presented at our emergency department with extensive swelling of the right foot, deformity of the fifth toe, bruising and intact skin. On clinical examination the phalangeal bone could not be palpated in the fifth toe and there was no capillary refill. The patient underwent open reduction combined with fasciotomies. The toe regained perfusion after the reduction and was under close observation to ensure its viability. Finally the distal and part of the middle phalanx of the toe was amputated. The purpose of this report is to inform health providers about this unique type of injury and contribute to a more sufficient treatment plan. Level of evidence: IV.

Closed Degloving Injury of the Foot Caused by a High Impact Force: A Case Report

“…Fifty-eight of the remaining articles were about open degloving injuries or very severe injuries involving multiple tissue layers, and 13 were reviews describing general management strategies. In all, there were 10 case reports/case series with 11 patients who had an isolated foot injury causing a degloving [5][6][7][8][9][10][11][12][13][14][15]. All of these described the empty toe phenomenon, which is a form of closed degloving foot injury where the toe is translocated.…”