Long-Term Results of Salvage Surgery in Severely Injured Feet

Background: The purpose of our study was to analyze the long-term outcome of salvage surgery in severely injured feet. Material and Methods: Clinical-functional scores and radiographic findings were used to assess the outcome of 18 patients (19 feet) with severe trauma to the foot treated at a tertiary teaching hospital from January, 1985 to October, 2005. Fourteen males and four females with a mean age of 35 years were studied. The mean followup period was 76 months. Results: There was a high incidence of late complications and poor functional results (mean AOFAS = 68/100): chronic pain, 15 of 19 (mean analogical pain score 3.4/10); global foot stiffness, 11 of 19 (with radiographic evidence of arthritis of the remaining foot joints in 13 of 19); residual deformity, 13 of 19; arterial-venous insufficiency, 12 of 19; signs of reflex sympathetic dystrophy, seven of 19; chronic ulcers, six of 19; and chronic osteomyelitis, two of 19. Twelve patients had a visible limp and only 8 of 19 returned to work. Conclusions: Five years after severe foot injury most patients had painful stiffness and only 40% returned to work. Long-term clinical-functional results of the severely injured foot may be disappointing.