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A Mouse Model of Ankle-Subtalar Complex Joint Instability

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Published on: October 28, 2022

Combat foot and ankle trauma.

Scott M Tintle¹, John J Keeling, Scott B Shawen

¹Orthopaedic Surgery Service, Washington, DC, USA.

Journal of Surgical Orthopaedic Advances

|April 8, 2010

Summary

This summary is machine-generated.

Limb salvage for severe lower extremity injuries, especially foot and ankle trauma, should be prioritized when possible. Aggressive early treatment, including debridement and fixation, is crucial for optimizing outcomes in complex combat-related injuries.

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Published on: January 23, 2018

Area of Science:

Orthopedic Surgery
Trauma Surgery
Military Medicine

Background:

Lower extremity injuries, particularly to the foot and ankle, are prevalent in modern conflicts.
Surgical advancements enable limb salvage, but reliable predictive scoring systems for amputation versus salvage are lacking.

Purpose of the Study:

To emphasize the importance of attempting limb salvage for lower extremity trauma when feasible.
To outline principles for managing complex foot and ankle injuries in a combat setting.

Main Methods:

Aggressive debridement and external fixation of fractures at the time of injury.
Serial debridements and wound management until closure or coverage.
Specific techniques for forefoot, midfoot, and hindfoot/calcaneal injuries, including arthrodesis and antibiotic spacers.
Management of blast injuries with potential for early amputation or limb salvage.

Main Results:

Limb salvage should be attempted preferentially due to limitations in predictive scoring systems.
Complex injuries require tailored approaches, with amputation sometimes necessary for calcaneal fractures with soft tissue compromise.
Blast injuries often involve multiple fractures, with early amputation considered at specialized centers.

Conclusions:

Prioritize limb salvage for lower extremity trauma in conflict zones whenever feasible.
Adherence to basic principles of aggressive debridement, fracture stabilization, and staged reconstruction is vital for successful limb salvage.
Definitive treatment may be deferred, allowing for later optimization of salvage outcomes.