Lahore Wheel Spoke Injury Classification

Usman Ishaque; Ata Ul Haq; Ahsan Riaz; Usman Kahlid; Muhammad Younas Mehrose; Ahmed Tarek Emam

Author(s)

Usman Ishaque Department of plastic Surgery, Mayo Hospital Lahore, Pakistan

Ata Ul Haq Jinnah Burn & Reconstructive Surgery Center, AIMC, Lahore, Pakistan

Ahsan Riaz Department of Plastic Surgery, SIMS, Lahore, Pakistan

Usman Kahlid Department of plastic Surgery, Mayo Hospital Lahore, Pakistan

Muhammad Younas Mehrose Jinnah Burn & Reconstructive Surgery Center, AIMC, Lahore, Pakistan

Ahmed Tarek Emam Welsh Center for Burns and Plastic Surgery, Swansea Bay University Health Board, UK

Abstract

Background: Pakistan has seen an increase in wheel spoke injuries of the foot as motorcycles become a more popular mode of transportation. The resulting injuries can range from minor abrasions to mangled feet that need to be amputated. Currently, there is no comprehensive classification that can categorize the wide range of injuries that have been observed. Objective: This study aims to critically evaluate the classifications used to describe wheel spoke injuries and define the subtypes that these classifications did not cater for. As a result, the Lahore Classification, a new classification for wheel spoke injuries, is being proposed, along with management for each subtype. Methodology: Retrospective study of a total 156 wheel spoke injuries of foot was undertaken to categorize/ classify these injuries in terms of injured structures. Wheel spoke injury patients of all ages and both genders; evaluated and admitted in Jinnah Burn & reconstructive surgery Centre (JB&RSC), Jinnah hospital/AIMC, Lahore, Pakistan were included in this study from January 2019 to December 2023. Results: A total of 156 “Wheel Spoke Injury” patients involving feet presented to our department. Injury mechanism and structures involved were noted. There were 42 patients who did not fit in specific grades of the existing classifications. A modification in the existing classification for the wheel spoke injury was devised and management of different subtypes was undertaken. The proposed algorithm for management ranges from conservative care to the need for free flap to cover the defect. Conclusion: Wheel spoke injuries of the foot can be managed more effectively with the help of a practical grading system. We propose a revised classification that will guide the management plan and a treatment algorithm which will ultimately improve the patient's outcome.

Publication Details

Page(s) 0-0

DOI DOI not available

Published Journal: Pakistan Journal of Plastic Surgery, Volume: 12, Issue: 2, Year: 2024

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Keywords

Classification, Lahore, Achilles tendon, Calcaneal Fracture, Wheel Spoke Injury, Calcaneum, Tibial Nerve

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