Limb Salvage for a Mangled Foot: A Case Report
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Published on: March 16, 2022
Takahiro Oda1, Keisuke Oe1, Atsushi Sakurai2
1Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
Introduction:
It remains controversial whether amputation or limb salvage is the best approach for mangled foot cases because there are no clear criteria for treatment. We report a case of successful limb salvage for a mangled foot, with good outcomes.
Case Report:
The patient was a 30-year-old man who sustained a crush injury to his left foot and ankle and lower legs in a car crash; he had severe open left foot and ankle fracture and bilateral open tibial shaft fractures. Blood flow was maintained by the posterior tibial artery, and the tibial nerve was intact. We stabilized the ankle using Kirschner wires on the day of injury. Plastic surgeons were consulted for early soft tissue coverage. Final fixation was performed 12 weeks after flap grafting; we grafted an autologous bone on the defect, according to the Masquelet technique. Four months after the final surgery, fullweightbearing gait was initiated. The patient is now capable of walking independently, with no pain, and is highly satisfied.
Conclusions:
Limb salvage can be successfully performed even in a patient with a severely mangled foot. For successful salvage surgery with good outcomes, such patients should be managed by a team of experienced orthopedic and plastic surgeons from an early stage to achieve appropriate bone alignment and soft tissue coverage.
