Gunshot wounds of the foot.

It is imperative that the physician participating in the care and treatment of foot and ankle trauma appreciate the epidemiology, the unique characteristics, and principles of treatment of gunshot injuries involving the foot and ankle. The current author will provide the reader with knowledge of how the bullet velocity, its mass, and its area are important in determining the energy transmitted to the tissues struck by the bullet. These forces imparted by the projectile interact with the specific characteristics of the tissues to determine the nature and extent of the trauma sustained by the foot and ankle. An understanding of the appropriate grading of the injury will allow for a rationale approach to the treatment of these injuries. The hallmark of treatment includes rigid skeletal fixation, revascularization, and treatment of soft tissues including appropriate wound coverage techniques.