Traumatic forefoot amputation in a 3-year-old boy caused by a lawnmower injury.

[INTRODUCTION] Lawn mower injuries represent a rare cause for severe limb threatening wounds of the lower extremity in children. Most patients can be treated with simple wound treatment involving debridement and VAC therapy,. Major amputation injuries requiring prolonged treatment and follow-up surgeries are relatively rare. In such cases, a multidisciplinary approach is often required. As part of the surgical management, the biomechanics of gait must be considered by the orthopedic team to ensure that a physiological gait pattern is maintained in these typically young patients.

[PATIENT AND METHOD] The present case reports the multidisciplinary management of a 3-year-old boy who was the victim of a lawnmower accident resulting in a traumatic forefoot amputation of the left foot at the level of the Chopart joint line. Furthermore, the talus exhibited a large bony defect in the anterior weight-bearing area. This is shown by the initial x-ray of the remaining hindfoot.

[RESULTS] Through the combined intervention of orthopedic reconstruction and plastic surgical coverage, it was possible to avoid a below-knee amputation, which was naturally a potential consideration in the presented case. Through multidisciplinary treatment we reached a functional, weight-bearing foot without an expected leg-lentgh-discrepancy.

[DISCUSSION] In cases of traumatic foot amputations, an individual assessment is necessary to determine the best course of treatment. The goal is to ensure a swift and clean procedure while minimizing long-term limitations as much as possible. A multidisciplinary treatment decision should always be made. Given the various amputation options, priority should be given to those that do not significantly alter the leg length. This approach ensures greater patient satisfaction and fewer limitations in daily life.

[LEVEL OF EVIDENCE] IV - Case Report.