Khairul Faizi Mohammad, Brad Yoo
Markku T Nousiainen, Richard Buckley
A detailed history of the traumatic event should be recorded to understand better the forces involved, which may help anticipate patterns of injury and soft tissue compromise.
Identifying pre-injury ambulatory status, nicotine use, occupational status, diabetic vasculopathy, previous bony or soft tissue injuries, or existing arthritis helps guide decision-making and estimate outcomes.
Clinical examination should include evaluation of:
What is observed:
What it indicates:
This case shows severe soft-tissue swelling and dead tissue after a forefoot crush injury.
Instability tests will sometimes need to be performed with a regional block or under general anesthesia.
Pain will indicate injuries to underlying structures.
The following views should be taken:
The joint proximal and distal to the suspected injury should be included in the radiograph.
Fractures and dislocations are usually evident in these views.
Fractures of the proximal metatarsals should raise suspicion for Chopart and/or Lisfranc injuries.
CT images are particularly useful to identify:
What is seen
What it indicates