Tibial fractures associated with crush injuries to the soft tissues of the dorsal foot in children.

We retrospectively studied 15 children with tibial fractures associated with crush injuries to the soft tissues of the dorsal foot. The fractures, including six open fractures, were united with no complications within an average of 11.1 weeks. Wound closure to treat crush injuries of the dorsal foot was achieved using split- or full-thickness skin grafts in most patients. The outcomes of these grafts were acceptable, and all skin coverage was successful and remained viable with no breakdown. Extensor tendon injuries of the foot sustained by eight patients could not be sutured or repaired due to the nature of the injuries. However, the functional abilities of those injured tendons that could be sutured to surrounding tissues in a neutral position were acceptable, even though two patients had contracture of the toes that was problematic when wearing shoes. To manage crush skin injuries of the dorsal foot, split- or full-thickness skin grafts appear to provide a simple and convenient treatment strategy. In cases associated with extensor tendon injuries, suturing damaged extensor tendons to surrounding tissues represents another useful strategy with acceptable outcomes.