BILATERAL CRUSH INJURY FOOT - FREE GRACILIS FLAP COVERAGE - K WIRE FIXATION - SKIN GRAFTING | CRUSH INJURY FOOT, LOWER LIMB INJURIES AND LIMB SALVAGE

A young adult male sustained injury to bilateral foot while working on a harvesting machine. he was managed by

First setting of surgical debridement , K- wire fixation of metatarsal fractures, Tendon repair of extensor digitiorum in right foot for 2nd toe , primary repair of skin in left foot.
Free Gracilis muscle transfer with skin grafting on right foot in 2nd setting

his pictures are shown below

PRESENTING PICTURE - CRUSH INJURY RIGHT FOOT

RADIOGRAPH OF RIGHT FOOT

PRESENTING PICTURE LEFT FOOT

RADIOGRAPH OF LEFT FOOT

PICTURE AFTER DEBRIDEMENT AND K-WIRE FIXATION

PLANTAR VIEW OF BILATERAL FOOT

RADIOGRAPH OF RIGHT FOOT SHOWING K- WIRE FIXATION - NOTE THE BONE GAP DUE TO BONE LOSS

RADIOGRAPH OF LEFT FOOT SHOWING K- WIRE FIXATION

CLOSE UP VIEW OF ANASTAMOSIS TO DORSALIS PEDIS ARTERY ,

End to side anastamosis was doen to dorsalis pedis artery and
End to end to venae comitantes

GRACILIS MUSCLE FLAP AFTER INSETTING IN RIGHT FOOT.

Gracilis muscle flap was grafted in the same setting to avoid another surgery, post operative monitoring was done using hand held doppler and flap colour monitoring through a skin window. post operative period was largely uneventful. patient was discharged shortly thereafter

HEALED BILATERAL FOOT. - SMALL RAW AREA ON DORSUM LEFT FOOT EXPECTED TO HEAL WITH DRESSINGS ALONE.

PICTURES AT 2ND FOLLOW UP AT ONE MONTH AFTER SURGERY

PATIENT WAS NOT ON FOLLOW UP FOR ONE YEAR AND THEN ONE DAY CAME FOR SOME BREAKDOWN OF SKIN ON DORSUM FOOT . HE WAS NOT APPLYING COCONUT OIL ON THE SKIN GRAFTED DORSUM. NOT SINUS OR INFECTION WAS FOUND.

PICTURES AT FOLLOW UP AFTER ONE YEAR OF INJURY