Mechanism of Injury

Mainly occur due to weight falling on the foot or foot getting crushed under the wheel of the vehicle.

Problems

These innocuous looking injuries, if not compound, can some times cause severe increase in the compartment pressure due to enlarging hematoma. This causes excruciating pain, disproportionate to the radiological appearance of the injury. This pain is difficult to relieve with analgesics. OnIy way to relieve the pain is to do surgical decompression. If not decompressed early, this can lead to ischaemic contracture ( Volkman's ischaemic contracture ) of the small muscles of the foot leading to clawing of toes.

Management

Management consists of Closed or open reduction of fractured fragments and stabilisation with K wires or only a plaster cast. Rarely one may need external fixation in distraction mode to stabilise these injuries.