Open wound management: meticulously remove ischemic tissue and debris from wound, lavage Wound: lavage copiously and perform deep wound culture.
Following open wound management, prosthetic repair of deficient collateral ligaments using non-absorbable material - short and long functional components should be repaired independently to give stability to the joint in flexion and extension respectively.
More extensive wounds are best managed with supportive external skeletal fixation until granulation tissue has covered the defect - delayed primary closure or skin grafting is then appropriate +/- prosthetic replacement of collateral ligament Skin graft: free.
If axial part of trochlear ridge is involved or joint stability cannot be achieved, talocrural or pantarsal arthrodesis Arthrodesis: pantarsal may be indicated.
Open wound management plus surgical repair plus external skeletal fixation plus antibiotic therapy specific to culture results Therapeutics: antimicrobial drug.