Komplextrauma des Fußes und Sprunggelenks: frühe und definitive Behandlung

The literature shows a strong association between complex foot and ankle trauma and polytrauma (up to 52% of cases). It has been estimated, that between 10 and 15% of all foot and ankle fractures fulfil the criteria of complex foot and ankle trauma. Complex trauma of the foot and ankle is a predictor of unfavorable outcome in polytraumatized patients. The treatment objective of complex foot and ankle trauma is the restoration of lower limb function which ideally should be painless, stable and functional whilst avoiding complications such as infection. Initial management of complex injuries of the foot requires recognition and treatment of compartment syndromes, early soft-tissue coverage, and rigid skeletal stabilization to enhance soft-tissue healing. Early total care should be adopted when both the patient's systemic condition and the local conditions are adequate to support the duration of the procedures. Staged treatment may be required in patients that have suffered life threatening injuries or were soft tissue cannot support duration of surgery. Site specific details and patient characteristics need to be appreciated when dealing with complex foot ankle injuries especially when amputation or reconstruction are discussed.