Date: Thu, 8 Aug 2002 12:10:06 +0300

Subject: Foot crush + alkali burn

Dear colleagues!

Please, advise!

Male, 48 y.o. foot was crashed by 2 tons weight + alkali burn.

Diagnosis: a combined trauma of right autopodium (tarsus), extensive laceration and degloving, 2nd degree chemical burn up to 1 % of a body surface, closed fracture of navicular and clinoid (cuneiform?) bones.

Operation: debridement, drainage, immobilization by back plaster.

Question: tactics of the next treatment?

Best wishes,

dr. Anton Vladzymyrskyy
R&D Institute of Traumatology and Orthopedy
Donetsk, Ukraine

Reply at: Orthopaedic Trauma Association forum

Date: Thu, 8 Aug 2002 09:29:06 +0000

From: b.meinhard

Percutaneous fixation with wires or screws under image control to reduce and hold the separated midfoot segments would be minimally traumatic while you wait for the soft tissues to declare themselves (which could take 5- 21 days). Then decide to excise, debride any necrotic tissue, and appropriately graft when a healthy granulating bed is present. Splint in neutral to avoid secondary contracture.