Fractures of the foot and ankle

Fractures of the foot and ankle are common in all age groups. Soft tissue swelling, smoking and co-morbidities such as diabetes mellitus and peripheral vascular disease should be considered when forming the management plan.Careful attention to neurovascular status and the soft tissue envelope of the foot and ankle is essential to the management of these injuries especially where crush injuries have occurred. Open fractures should be treated urgently with a combined approach with the plastic surgeons.A good understanding of surgical anatomy is key to managing these fractures. Good intra-articular involvement and ligamentous stability are crucial in predicting long-term prognosis.The core principles of management are: to maintain the soft tissue envelope (minimize disruption); to obtain appropriate alignment; restoration of joint surfaces; and rehabilitation to obtain optimum function.