Foot Reconstruction of Severe Bone and Soft Tissue Landmine Injury

Abdulmalik Adel,Randa Aldaghili,Salem Elmabsout

doi:10.4172/2572-5130.1000171

Abstract

Landmine Injury to the foot and ankle as high-force energy can be devastating to a different structure including bone, muscles, vessels, and nerves. The degree of tissue destruction and often other surgical evaluation most likely to affects the decision of whether to amputate or attempt a reconstruction. In Literature, previous studies show that immediate amputation in patients with high Mangled Extremity Severity Score (MESS) had a very good prognosis compared with reconstruction. In this paper, we report a case of a 28-male presented to the Emergency Department at ALJALA hospital after 30 minutes of crushing his right foot by direct contact with a landmine. Assessment of the patient revealed poor general state and the foot was severely mangled despite >7 on Mangled Extremity Severity Score (MESS). Limb salvage was used with Aggressive debridement, reduction with external fixation, skin graft with big toe amputation and later replace of skin graft with sural flap. After one year of treatment, all wounds healed completely with little pain, satisfactory motor and sensory functions were achieved and the patient returns to his previous job as vehicle driver. In conclusion, the treatment of mangled extremity should be based on clinical evaluation of every patient. Guidelines and scores are helpful, but should not be considered as fundamental criteria in clinical decisions.

Highlights

A 28-year-old Libyan male was admitted to the orthopedic department in the ALJALA hospital in Benghazi with the diagnosis of a severe bone and soft tissue injury of the right foot
All wound were healed with little pain (Figure 6), and there was no pathological mobility of bone fragments
The patient was very satisfied with the treatment result with satisfactory motor and Sensory functions, and he returns to his previous job as a vehicle driver

Summary

Introduction

A 28-year-old Libyan male was admitted to the orthopedic department in the ALJALA hospital in Benghazi with the diagnosis of a severe bone and soft tissue injury of the right foot. The right foot had severe bone and soft tissue injuries with about 25 cm contaminated wound that extends from posteromedial aspect lower leg to medial, plantar and lateral aspect up to dorsum of foot (Figure 1).

Results

Conclusion