The impact of the Major Trauma Network: will trauma units continue to treat complex foot and ankle injuries?

Foot fractures and complex trauma of the foot: a case series

Foot fractures are common injuries. This retrospective study evaluates their frequency, incidence, treatment and outcomes with emphasis on complex trauma of the foot (CTF), an injury that affects soft tissue as well as bone. From 2005 to 2015, 506 patients with foot fractures were treated at our institution; of these, 27 had CTF. The Zwipp score was applied to diagnose CTF, the Gustilo-Anderson classification to grade open fractures and the Tscherne classification to grade closed fractures. Twelve months after the trauma, 20 CTF patients underwent the final X-ray assessment and clinical evaluation with the Visual Analogue Scale Foot and Ankle (VASFA), the Foot Function Index (FFI) and the 12-Item Short Form Survey (SF-12). Data were analyzed with the Spearman rank correlation test. The forefoot was the most frequently involved compartment both in patients with foot fracture and in those with CTF. At 12-month follow-up, the CTF patients showed a VASFA score of 51.5, an FFI of 47.5 and SF-12 scores of 37.9 (physical component summary) and 45.2 (mental component summary). The VASFA score and the FFI showed a significant correlation (rs = 0.84; p = 0.001). CTF is the cause of considerable residual disability and deeply affects quality of life.