Abstract
Necessity of secondary Syme amputation of the foot after severely destroyed hindfoot injury due to suicidal jump from height in a psychiatric patient: Case presentation and brief review of literature
Highlights
The right foot showed an open Gustilo-Anderson IIIB hindfoot injury at the medial-plantar aspect of calcaneus, and 3D CT revealed a highly comminuted calacaneus fracture (Figure 1B). Both injuries were initially treated by closed reduction and external fixation (CREF) accompanied with percutaneous pinning, negative-pressure vacuum assisted closure (VAC) therapy, and intravenous application of antibiotics
The overall pins for external and internal fixation of both foots had to be removed 4 weeks after primary surgery, resulting in severe posttraumatic flat foot on both sites based on pronounced bony destruction and fragment dislocation and diastases of the calcaneus bones accompanied with re-dislocation in her left Chopart joint (Figures 2A and 3A)
The further course after secondary wound closure of her open II injury without the need of coverage was complicated by development of severe osteomylitis of the hindfoot involving the distal tibia metaphysis presented with marked swelling of the overall foot and an infectious fistula at the lateral aspect of calcaneus (Staphylococcus aureus) (Figures 3A-B)
Summary
Necessity of secondary Syme amputation of the foot after severely destroyed hindfoot injury due to suicidal jump from height in a psychiatric patient: Case presentation and brief review of literature.
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