A 27-year-old male presented with incomplete left foot amputation caused by a machine accident. The foot was salvaged after two rounds of surgery, but was insensate due to tibial nerve injury. This unusual sensation bothered the patient after surgery, but he was able to be barefoot at 5 months postoperatively. Eleven months later, he was able to jog using an ankle-foot orthosis, the reformation of inversion and equinus strap, with slight pain and no medication. Treatment of severe lower extremity trauma is complex and challenging. Early amputation may result in better long-term outcomes than limb salvage for some patients; however, no established guidelines are available to make informed treatment decisions. Although all injury characteristics are significant indicators of limb status, soft tissue injury and absence of plantar sensation are the most important. Previous studies reported that initial plantar sensation is not a prognostic factor for long-term plantar sensory status or functional outcome, and should not be a component of limb-salvage decision algorithms. Our case demonstrates the importance of limb salvage even for a patient with tibial nerve injury secondary to incomplete foot amputation.
