osteolyelitis

i have a question and i hope to find anwsers here. i have a patient who fell and injured his great toe badly. when he was admitted to our home health service, he'd been in the hospital for a few days and they have sewn back his toe. during my 2 weeks of care he did not have a temperature, foul smell to the site, or purulent drainage. the toe was tender to touch but i thought it was from the trauma, and it had some escar on top of the top. last week i sent him to the MD due to his pain, i thought the escar had to be removed. came to find out the MD decided he had osteomyelitis and they are going to amputate the toe. i was not aware that the bones were exposed from the initial injury.

was there something i could've done different? the patient is now upset and he think if i had sent him to the doctor he may could save the toe, but i am thinking back really hard and i couldn't think of any signs of symptoms that would've told me something was wrong. i'd like to know what else i coul've done so i can provide better care in the future