Trash Foot Syndrome: A Case Report

BACKGROUND

Trash foot   syndrome (TFS), also known as blue toe syndrome (BTS) and occlusive   vasculopathy, is the appearance of   a bluish cyanotic discoloration of the forefoot   caused by the occlusion of small- to medium- sized arteries of the ankle and   foot by fibrino-platelet micro-emboli. The source of these micro-emboli is   hypothesized to arise from an atherosclerotic plaque in the aorta or the large arteries distal   to the aortic bifurcation. The term BTS is sometimes interchanged with cholesterolembolization syndrome (CES). TFSisone   of several end-results of CES. TFS is rarely encountered by the orthopedic surgeon; the antecedent CES is commonly unrecognized. Here we   discuss a 74-year- old hemodynamically stable post-total hip arthroplasty   (THA) patient at the Philippine Orthopedic Center   (POC) who developed acute cyanosis and gangrene of the ipsilateral foot.