Don't Forget About the Foot

Foot injuries in polytrauma patients are often overlooked because life-threatening injuries take priority. A recent retrospective registry analysis conducted at Tampere University Hospital from 2016 to 2023 assessed the frequency and timing of foot injuries in polytrauma patients and identified factors that lead to delays in diagnosis. The methods involved included:

• Selecting polytrauma patients with NISS of 16 or higher

• Screening for specific types of foot fractures, such as Lisfranc injuries and Chopart injuries

Key findings from the study revealed:

• Foot injuries were present in 4.1% of patients (54/1327).

• 215 foot injuries, mostly fractures, were recorded.

• Diagnoses were delayed (more than 24 hours after submission) in 43% of patients and 37% of the injuries.

• The most delayed diagnoses were midfoot and metatarsal fractures.

Risk factors for delay

Several risk factors for delayed diagnosis include:

• More foot injuries

• Lower GCS score

• Concomitant facial injuries

Bottom line

Delayed diagnosis of foot injuries is common. The foot and ankle team can help by emphasizing extremity screening in trauma protocols after rendering acute life-saving care.