Physical therapy of the patient with foot and ankle injuries sustained in combat.

The rehabilitation of soldiers returning from Operation Iraqi Freedom and Operation Enduring Freedom after combat-related trauma poses significant challenges. Polytrauma from high-energy blasts are common and frequently associated with mangled extremities, axial fractures, and traumatic brain injuries. Current evidence in the physical therapy literature is scant for this population and an empiric approach is often used. This article highlights the challenges encountered and techniques used in the rehabilitation of soldiers with foot and ankle injuries sustained in recent combat operations.

[1]  K. Refshauge,et al.  Rehabilitation for ankle fractures in adults. , 2008, The Cochrane database of systematic reviews.

[2]  D. Herscovici,et al.  A staged protocol for soft tissue management in the treatment of complex pilon fractures. , 1999, Journal of orthopaedic trauma.

[3]  K. Refshauge,et al.  Manual therapy in addition to physiotherapy does not improve clinical or economic outcomes after ankle fracture. , 2008, Journal of rehabilitation medicine.

[4]  Robert D Herbert,et al.  Passive stretching does not enhance outcomes in patients with plantarflexion contracture after cast immobilization for ankle fracture: a randomized controlled trial. , 2005, Archives of physical medicine and rehabilitation.

[5]  L. Wallenberg Effect of early mobilisation after skin grafting to lower limbs. , 1999, Scandinavian journal of plastic and reconstructive surgery and hand surgery.

[6]  Kristin R. Archer,et al.  Gait Symmetry and Walking Speed Analysis Following Lower-Extremity Trauma , 2006, Physical Therapy.

[7]  E. Hendriks,et al.  Effectiveness of exercise therapy and manual mobilisation in ankle sprain and functional instability: a systematic review. , 2006, The Australian journal of physiotherapy.

[8]  J. Ponsford,et al.  Factors influencing outcome after orthopedic trauma. , 2008, The Journal of trauma.

[9]  M. A. de Resende,et al.  Force-displacement relationship during anteroposterior mobilization of the ankle joint. , 2008, Journal of manipulative and physiological therapeutics.

[10]  Kristin R Archer,et al.  Evidence of beneficial effect of physical therapy after lower-extremity trauma. , 2008, Archives of physical medicine and rehabilitation.

[11]  Robert Gringmuth,et al.  Therapeutic Exercise For Spinal Segmental Stabilization in Low Back Pain: Scientific Basis and Clinical Approach. , 2000 .

[12]  Jane M. Young,et al.  Predictors of general health after major trauma. , 2008, The Journal of trauma.

[13]  T S Buchanan,et al.  Ankle inversion injury and hypermobility: effect on hip and ankle muscle electromyography onset latency. , 1995, Archives of physical medicine and rehabilitation.

[14]  M. McKee,et al.  Do foot injuries significantly affect the functional outcome of multiply injured patients? , 1999, Journal of orthopaedic trauma.

[15]  James F Kellam,et al.  Long-term persistence of disability following severe lower-limb trauma. Results of a seven-year follow-up. , 2005, The Journal of bone and joint surgery. American volume.

[16]  J. E. Earl,et al.  Resistance training is accompanied by increases in hip strength and changes in lower extremity biomechanics during running. , 2009, Clinical biomechanics.

[17]  P. Hodges,et al.  Altered trunk muscle recruitment in people with low back pain with upper limb movement at different speeds. , 1999, Archives of physical medicine and rehabilitation.

[18]  Arul Ramasamy,et al.  Injuries from roadside improvised explosive devices. , 2008, The Journal of trauma.

[19]  R. Andersen,et al.  Short-term outcomes of severe open wartime tibial fractures treated with ring external fixation. , 2008, The Journal of bone and joint surgery. American volume.

[20]  M. Mazurek,et al.  The Scope of Wounds Encountered in Casualties From the Global War on Terrorism: From the Battlefield to the Tertiary Treatment Facility , 2006, The Journal of the American Academy of Orthopaedic Surgeons.

[21]  Jakub Szajman,et al.  Fibre optic shock velocity sensor for solids , 1999 .

[22]  K Rome Invited commentary: does stretching increase ankle dorsiflexion range of motion: a systematic review [by Radford JA, Burns J, Buchbinder R, Landorf KB, Cook C] , 2006 .

[23]  K. Refshauge,et al.  Rehabilitation for ankle fractures in adults. , 2012, The Cochrane database of systematic reviews.

[24]  D. Thordarson,et al.  Functional Outcome of Multiply Injured Patients with Associated Foot Injury , 2002, Foot & ankle international.

[25]  Brett D Owens,et al.  Resource Utilization and Disability Outcome Assessment of Combat Casualties From Operation Iraqi Freedom and Operation Enduring Freedom , 2009, Journal of orthopaedic trauma.

[26]  John F Kragh,et al.  Combat wounds in operation Iraqi Freedom and operation Enduring Freedom. , 2008, The Journal of trauma.

[27]  R. Buchbinder,et al.  Does stretching increase ankle dorsiflexion range of motion? A systematic review , 2006, British Journal of Sports Medicine.

[28]  M. Ferreira,et al.  Changes in Recruitment of the Abdominal Muscles in People With Low Back Pain: Ultrasound Measurement of Muscle Activity , 2004, Spine.

[29]  K. Vandenborne,et al.  Effects of immobilization on plantar-flexion torque, fatigue resistance, and functional ability following an ankle fracture. , 2000, Physical therapy.