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

2. Case description
Grade III open Lisfranc fracture dislocation with loss of dorsal skin

3. Discussion How would you manage this soft-tissue defect? Skin grafting
Local flap
VAC dressing
Free flap—facial flap or muscular flap
Consult/refer to a plastic surgeon

4. Function 18 months postinjury
Free radial forearm flap at 48 hours postinjury

5. Take-home messages Early radical debridement to prevent infection
Early soft-tissue coverage and skeletal stability
Local or free flaps if there are exposed bones, tendons, joints