Salvage or amputation after complex foot and ankle trauma.

A treating surgeon must take all the aforementioned ideas and principles into consideration, make a reasoned decision in the first hour of patient evaluation, and proceed with the chosen treatment. When functional salvage is not thought to be possible, it is better simply to let the patient and family know, then proceed directly to the best possible reconstructive amputation. This approach saves the patient, family, friends, and treatment team an enormous amount of anguish and allows for the earliest possible acceptance and positive approach to rehabilitation.