Temporary Bridging of Severe Medial Column Injury of the Foot using Internal Fixation

Inadequate treatment of midfoot crush injury often leads to permanent disability. The principle of treatment is to restore foot column length and joint congruity while it is stable enough to allow an early rehabilitation. Choices of treatment include external fixation plus pinning, circular frame fixation, and open reduction plus internal fixation. External fixation is minimally invasive but it poses the threat of inaccurate reduction, loss of reduction secondary to pin loosening, and pin tract infections. Open reduction and internal fixation per se allows good reduction of fragments and restoration of joint congruities but it lacks the protection of the whole construct. We report a case of severe midfoot crush injury that was treated with temporary bridging fixation using a low-profile locking plate. It is an evolving technique that solves the problems of external fixation, and a stable construct can be achieved for early weight bearing