In the emergency room, she received tetanus vaccination and intravenous antibiotic treatment including vancomycin and amikacin according to our hospital protocol. She was operated 60 min after arrival to the hospital.

During the operation under general anesthesia, we conducted massive washing with 10 L NS, and radical debridement of all in vital tissue and remained foreign bodies was done; cultures were taken from the debrided tissue.

A stabilization of the foot and ankle was achieved by fixing her fracture using circular thin wire external fixation frame (Fig. 20.2), and we left her wounds unsutured and dressed with vacuum drainage dressings (Fig. 20.3
).