Trauma Workshop 1

25 year old male presents to the ED after being in a motorcycle accident with a severe injury to his left
foot and ankle. He is brought by ambulance and has been cleared by the trauma team except his foot
and ankle.

What else would you like to know?

How would you classify? How would you treat the injury shown below?

Case 2: A 12 yo girl presents to the ED after stepping on a rake in her yard.

From the picture below what else would you like to know? How would you treat? What further
considerations should you have? Complications?
Case 3: A 72 year old male presents to the ED 8 hours after falling down his steps with inability to bear
weight to his right foot.
What else would you like to know? How do you classify? How would you treat?
Case 4: 33 yo male presents to the ED after he reports being on the street corner minding his own
business when some guy just started shooting at him.

What else do you want to know? How do you want to treat?

Compartment syndrome: emergent fasciotomy if pressure greater than 30mm/Hg or if 10-
30mm/Hg less than diastolic pressure.
9 foot compartments: deep, superficial, calcaneal, medial, lateral, 4 interspaces.
9 major compartments of foot have been described

medial

o abductor hallucis

o flexor hallucis brevis

lateral

o abductor digiti minimi

o flexor digiti minimi brevis

interosseous (x4)

central (x3: superfical, middle, and deep)

o superficial - flexor digitorum brevis

o central/calcaneal - quadratus plantae

o deep - adductor hallucis (includes posterior tibial neurovascular bundle)