title: War wounds of the foot and ankle: causes, characteristics, and initial management.
abstract: Foot and ankle trauma sustained in the Global War on Terror have unique causes and characteristics. At least one-quarter of all battle injuries involve the lower extremity. These severe lower extremity wounds require specialized early treatment. Ballistic mechanisms cause almost all injuries, and as such, most combat foot and ankle wounds are open in nature. Wounds are characteristically caused by blast mechanisms, but high velocity gunshot injuries are also common. The severe and polytraumatic nature of injuries sustained frequently call for damage control orthopaedics to be utilized. Cautious early treatment of irregular and highly exudative ballistic wounds with subatmospheric wound dressings may ease their early management.
authors.affiliation: Foot and Ankle Service, Department of Orthopedics, Brigham & Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. ebluman@partners.org
authors.forename: Eric M
authors.initials: EM
authors.lastname: Bluman
authors.forename: James R
authors.initials: JR
authors.lastname: Ficke
authors.forename: Dana C
authors.initials: DC
authors.lastname: Covey
mesh_terms: D016512:Ankle Injuries / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D001753:Blast Injuries / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016267:External Fixators; D005260:Female; D018409:Foot Injuries / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D005597:Fractures, Open / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D023821:Limb Salvage / Q000379:methods; D008297:Male; D008889:Military Personnel; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000379:methods; D018570:Risk Assessment; D017695:Soft Tissue Injuries / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D013524:Surgical Flaps; D014857:Warfare; D014945:Wound Healing / Q000502:physiology