Case for small group discussion Complex foot trauma Case for small group discussion AOTrauma—Foot & Ankle Module 6: Soft-tissue trauma Stefan Rammelt, DE

Case description 17-year-old man Suicide jump (6th floor) Polytrauma (head, spine injury) Deep open wound on the lateral aspect of the hindfoot (down to the calcaneus)

Crush injuries Day 5 6 Months Day 1

6-month follow-up Stable soft-tissue coverage Plantigrade foot Spontaneous fusion of subtalar joint

Take-home messages Initial treatment—damage control surgery Primary debridement, percutaneous fixation Secondary internal fixation Early soft-tissue coverage PMMA beads with antibiotics as temporary defect filler