Case 16 2026: Severe Foot Degloving Injury Following a Forklift Crush: A Limb-Salvage Case

Keywords: Degloving injury, (decollement), foot trauma, limb salvage, fluorescence angiography, negative pressure wound therapy. Authors: Cecilie Jansen, Emil Villiam Holm-Rasmussen, Mette Stueland Wolthers. Copenhagen University Hospital, Rigshospitalet, Denmark. Abstract A 30-year-old previously healthy man was admitted to The Trauma Centre at Copenhagen University Hospital, Rigshospitalet after his left foot was crushed by a 1.5-ton forklift at work. He sustained a large open fracture and an extensive circumferential degloving injury involving the foot and ankle, while distal perfusion remained intact. Computed Tomography (CT) demonstrated multiple intra-articular fractures with suspected Lisfranc injury and no vascular injury on CT angiography. Following orthopedic stabilization, plastic surgical management focused on debridement, tissue viability assessment, skin and heel-pad preservation, and limb salvage. This case highlights the challenges of severe foot degloving and multidisciplinary limb-salvage management. Patient medical history The patient was previously healthy, had no significant past medical history, and was a non-smoker. Before and After Patient examination On arrival at The Trauma Centre at Copenhagen University Hospital, Rigshospitalet, the patient was hemodynamically stable but slightly pale. He reported paresthesia in the left foot, but gross sensation was preserved. Clinical examination revealed an approximately 15 cm open wound laterally on the left foot with exposed bone and tendon. A palpable pulse was present in the dorsalis pedis artery, whereas the posterior tibial artery pulse was not palpable. Capillary refill and sensation were preserved. A trauma CT scan with intravenous contrast, including CT angiography of the lower leg was performed. Imaging demonstrated multiple intra-articular fractures distal to the talus with widening between the second metatarsal and medial cuneiform, raising suspicion of a Lisfranc injury. Air was present in