Treatment of patients with fractures and displacement-fractures of the anterior and middle foot

To treat patients with fractures and displacement-fractures of the anterior and middle foot is a topical problem of ambiguous solution. The authors have developed their working classification, an algorithm for treating these patients, and a surgical procedure in accordance of this classification. All damages to the middle and anterior foot were divided into stable and unstable, isolated and multiple. A treatment option was chosen, depending on the functional characteristics of the damaged foot column. To prevent the development of compartment syndrome, if a postoperative wound could not be sutured without tension on its edges, a relaxing incision was made beyond the injury projection for soft tissue decompression; during medical treatment, if elevated interfascial pressures were suspected, dotted incisions were done along the dorsal surface of the foot. The wounds after the relaxing incision were managed openly until the traumatic edema disappeared, and were then sutured. One hundred and forty-two patients with damages to the anterior and middle foot (68 controls and 74 study group patients) were followed up at the Traumatology Departments of City Clinical Hospital Sixty-Four in 2002 to 2008. Assessment of treatment results validly showed an increase in the positive outcomes of treatment and a considerable reduction in complications.

foot, fractures, displacements, treatment