Punctured wound , oil palm's worker's occupational hazard

Few days ago , a guy walk in to my consultation room with pain and swelling of his right foot for 3 months.He says the pain comes on and off, but the swelling is always there.He gave history of kicking a bunch of oil palm's leaves , and hence the leg became painfull the next day.He has no history of gout or family history of gout.

He had minor aberation on the foot, which is bloodless and heal up in two days.He ignores it, didn't get any treatment from any doctor.A week or two later, he had some discharge from the site of aberation wound.It heals after he cleans up the wound.Yet it comes again after a week or two later.

When i saw him, there was a small wound and discharge on the dorsal of the right foot.It was painfull.I assure him there was something inside the wound. He allows me to do some digging work.There was a piece of oil palm's 'torn' as big as rice seed at the end of the 'tunnel'.

It was common to see oil palm's torn punctured through under the skin and left behind unnoticed.it is because they are very very brittle, yet sharp at the end of it so when enough force applied it can punctured through the skin, and snapped.Un suspecting medical personnel can missed it and the patient will suffer of non healing wound.Some how the body will attack this foreign body and produce puss ,as a mechanism of rejecting it.

Usually, after the foreign body removed, the wound cleanned, and some antibiotic given, the wound will healed up in a few days.Pain killer may help the patient , to keep up in mobility.