Initial Management of Severe Open Injuries and Traumatic Amputations of the Foot

Acute Management of Major Trauma Involving the Foot and Ankle with Hoffmann External Fixation

“…7 Neither did we find references devoted to the use of external fixation in acute footankle trauma. The one article by Omer and Pomerantz 7 presented 410 patients with open injuries to the foot seen at an Army medical center from 1966 to 1969.…”

Mechanisms and Outcomes after Crush Injuries of the Foot

“…Previous descriptions have focused on specific mechanisms of injury [12,13], broad descriptions of anatomical considerations and treatment [14], or group crush injuries together with all forms of complex foot injury [15]. Outcomes are similarly poorly defined, though one group has previously noted that up to 50% of patients required ambulation assistance following a crush mechanism [16]. This has prompted the publication of detailed management protocols for these injuries, in recognition of the unique pathophysiology of crush mechanisms [11,15].…”

“…Defining which injuries count as occurring via a crushing mechanism presents its own problems. Definitions vary, and include, "the result of a body part being forcibly compressed between two hard surfaces" [15], an "injury that occurs from an extrinsic compressive or shear force of variable magnitude applied to the foot over a variable time period" [11], and "direct physical trauma to the torso, extremities or other parts of the body from an external crushing force" [16]. This compression can cause ischaemia and swelling, and subsequent reperfusion injury can result in a secondary insult from cellular death, rhabdomyolosis and compartment syndrome [15,17].…”