PMC8696818_01
Intraoperative photograph of a near-complete amputation of the right forefoot of a 20-year-old man after a motorboat propeller injury.
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He had a 15- to 20-cm laceration extending from the base of the fifth metatarsal across the dorsum of the foot to the great toe with exposed subcutaneous tissue and apparent tendon lacerations (Figure 1).
(A) Preoperative nonweightbearing anteroposterior radiograph of the right foot in a splint after a motorboat propeller injury. (B) Preoperative nonweightbearing lateral radiograph of the right foot in a splint after a motorboat propeller injury. (C) Preoperative nonweightbearing oblique radiograph of the right foot in a splint after a motorboat propeller injury.
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There was also a corticated fragment proximal to the base of the fifth metatarsal (Figure 2a-c).
(A) Immediately postoperative nonweightbearing anteroposterior radiograph of the right foot in a splint. (B) Immediately postoperative nonweightbearing lateral radiograph of the right foot in a splint. (C) Immediately postoperative nonweightbearing oblique radiograph of the right foot in a splint.
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Intraoperative fluoroscopy was used to confirm adequate positioning for all of the reductions described above (Figure 3a-c).
Five-month postreconstruction photograph of the right forefoot after a motorboat propeller injury.
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At the 5-month postoperative visit, his wounds were healed (Figure 4) and he had good strength with ankle dorsiflexion and plantarflexion, although he had limited range of motion and weakness of his toes in dorsiflexion (extensor hallucis longus/extensor digitorum longus strength of 2/5, with a score of 5 indicating maximum strength).
(A) Anteroposterior weightbearing radiograph of the right foot 9 months after surgery for a motorboat propeller injury. (B) Lateral weightbearing radiograph of the right foot 9 months after surgery for a motorboat propeller injury. (C) Oblique weightbearing radiograph of the right foot 9 months after surgery for a motorboat propeller injury.
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Radiographs at the 9-month postoperative visit showed progression of healing of the fractures (Figure 5a-c).
(A) Anteroposterior weightbearing radiograph of the right foot 1 year after surgery for a motorboat propeller injury. (B) Lateral weightbearing radiograph of the right foot 1 year after surgery for a motorboat propeller injury. (C) Oblique weightbearing radiograph of the right foot 1 year after surgery for a motorboat propeller injury.
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Radiographs showed complete healing of the metatarsal shaft fractures with arthritis of the first metatarsophalangeal joint (Figure 6a-c).