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Published on: April 18, 2011
Traumatic forefoot amputation in a 3-year-old boy caused by a lawnmower injury
Manuel Gahleitner1,2, Sandra Feldler3,4, Lorenz Pisecky1,2
1Johannes Kepler University of Linz, Linz, Austria.
Insights
A 3-year-old boy with a traumatic forefoot amputation avoided below-knee amputation through multidisciplinary orthopedic and plastic surgery. This approach preserved a functional, weight-bearing foot without leg length discrepancy, ensuring better long-term outcomes.
Area of Science:
- Pediatric Orthopedics
- Trauma Surgery
- Limb Reconstruction
Background:
- Lawn mower injuries can cause severe, limb-threatening lower extremity wounds in children.
- Major amputations are rare but require prolonged treatment and multidisciplinary care.
- Maintaining physiological gait is crucial for young patients undergoing surgical management.
Purpose of the Study:
- To report the multidisciplinary management of a severe traumatic forefoot amputation in a child.
- To demonstrate the successful limb salvage and functional restoration in a complex pediatric amputation case.
Main Methods:
- Case report of a 3-year-old boy with traumatic forefoot amputation at the Chopart joint line and a talar bone defect.
- Multidisciplinary approach involving orthopedic reconstruction and plastic surgical coverage.
- Consideration of biomechanics for gait maintenance.
Main Results:
- Avoidance of below-knee amputation through combined surgical interventions.
- Achieved a functional, weight-bearing foot.
- No significant leg length discrepancy was observed post-treatment.
Conclusions:
- Individual assessment is vital for traumatic foot amputations to minimize long-term limitations.
- Multidisciplinary treatment decisions are essential for optimal outcomes.
- Prioritizing limb-sparing options that preserve leg length enhances patient satisfaction and daily function.
Introduction:
Lawn mower injuries represent a rare cause for severe limb threatening wounds of the lower extremity in children. Most patients can be treated with simple wound treatment involving debridement and VAC therapy,. Major amputation injuries requiring prolonged treatment and follow-up surgeries are relatively rare. In such cases, a multidisciplinary approach is often required. As part of the surgical management, the biomechanics of gait must be considered by the orthopedic team to ensure that a physiological gait pattern is maintained in these typically young patients.
Patient And Method:
The present case reports the multidisciplinary management of a 3-year-old boy who was the victim of a lawnmower accident resulting in a traumatic forefoot amputation of the left foot at the level of the Chopart joint line. Furthermore, the talus exhibited a large bony defect in the anterior weight-bearing area. This is shown by the initial x-ray of the remaining hindfoot.
Results:
Through the combined intervention of orthopedic reconstruction and plastic surgical coverage, it was possible to avoid a below-knee amputation, which was naturally a potential consideration in the presented case. Through multidisciplinary treatment we reached a functional, weight-bearing foot without an expected leg-lentgh-discrepancy.
Discussion:
In cases of traumatic foot amputations, an individual assessment is necessary to determine the best course of treatment. The goal is to ensure a swift and clean procedure while minimizing long-term limitations as much as possible. A multidisciplinary treatment decision should always be made. Given the various amputation options, priority should be given to those that do not significantly alter the leg length. This approach ensures greater patient satisfaction and fewer limitations in daily life.
Level Of Evidence:
IV - Case Report.
