Surgical Treatment of Severe Foot Injuries in Children

Crush injuries of the extremities is a severe type of trauma caused by significant mechanical force, resulting in damage to all tissue layers of the affected segment. An individualized approach is employed to achieve optimal treatment outcomes, involving multidisciplinary specialists—traumatologists, surgeons, rehabilitation physicians, anesthesiologists, and intensivists. This article presents two case reports of surgical treatment in children with foot crush injuries accompanied by extensive soft tissue defects. The key diagnostic steps are outlined, and principles of surgical decision-making and planning are discussed. Following necrectomy and bone fragment repositioning, various plastic reconstruction techniques were used to cover soft tissue defects, including local tissue flaps, free autografts, and full-thickness skin grafts on a vascular pedicle. The article describes the wound healing process and analyzes the outcomes of the performed surgical interventions. The included photographs illustrate pre- and postoperative stages. The staged surgical treatment resulted in limb preservation, bone consolidation with acceptable fragment displacement, closure of soft tissue defects, and restoration of lower limb function. These cases highlight the complexity and necessity of a multidisciplinary approach in managing pediatric foot crush injuries.