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Case report
‘Bastard bush’: acacia thorn injuries and management
  1. Simon Johnstone Smail1,
  2. C Arthur2,
  3. K Hylands3 and
  4. C J Stewart1
  1. 1 Defence Primary Health Care, Medical Reception Station Redford Barracks, Edinburgh, UK
  2. 2 Department of Trauma and Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK
  3. 3 Department of Medical Microbiology, Royal Infirmary of Edinburgh, Edinburgh, UK
  1. Correspondence to Dr Simon Johnstone Smail, Defence Primary Health Care, Medical Reception Station Redford Barracks, Edinburgh EH13 0PP, UK; Simon.Smail100{at}mod.gov.uk

Abstract

This case report outlines the presentation and management of a young soldier who sustained a lower limb acacia thorn injury while on exercise in Kenya. The injury failed to heal with a subsequent ultrasound scan revealing a large retained thorn requiring surgical removal and wash out. From this case, lessons can be learnt regarding the management of thorn injuries, which are common in exercising troops in Kenya and indeed around the world. The key take-home messages are always consider a retained thorn if wounds fail to settle, use ultrasound as the imaging modality of choice, always remove identified retained thorns and if antibiotics are required use broad-spectrum antibiotics pending culture results.

  • adult orthopaedics
  • primary care
  • accident & emergency medicine
  • orthopaedic & trauma surgery

http://dx.doi.org/10.1136/jramc-2018-000978

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    Footnotes

    • Contributors SJS pulled all the material, researched and wrote text. CA provided images and also advice and information regarding surgical aspects. KH helped write microbiology section and proof read text. CJS provided image of acacia bush and also proof read the article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; internally peer reviewed.