Foot and ankle reconstruction after blast injuries

Extremity trauma secondary to explosive devices is the most common injury incurred on the contemporary battlefield. Limb salvage is a viable alternative for the treatment of severe open fractures of the lower extremity created by blast injuries. For unilateral injuries, amputation may create a more functional outcome than limb salvage, especially when the open fractures are accompanied by significant soft tissue defects. Limb salvage requires a multidisciplinary effort to reduce complications and maximize success. New fixation devices and bone stimulating factors improve the ability to achieve bone union. The eradication of infection and reconstruction of compromised soft tissues remain the major obstacles to achieving superior functional outcomes. External ring fixators, such as the TSF, show great promise as the definitive fixation for blast fractures and as a reconstructive tool for dealing with residual soft tissue and bone defects.