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Management of Traumatic Foot Wounds

Department of Orthopaedics and Rehabilitation, University of New Mexico School of Medicine, Albuquerque.

The foot is frequently exposed to direct trauma due to its role in weight-bearing. The soft-tissue wounds that commonly result interfere with ambulation due to complications such as tissue necrosis, scar formation, infection, and deformity. The five most common categories of foot injury are (1) low-velocity blunt trauma, (2) high-velocity blunt trauma, (3) low-velocity penetrating trauma, (4) high-velocity penetrating trauma, and (5) thermal injuries. For major wounds, the treatment is early aggressive debridement, copious irrigation, and skeletal stabi-lization with early coverage of skin defects. Local and systemic antibiotics are adjunctive to debridement to prevent infection. Prompt recognition and release of compartment syndrome of the foot are extremely important. Close observation is appropriate for wounds that appear minor on initial evaluation.