The mangled foot and ankle can be defined as a severe injury to multiple organ systems of this appendage that can include bone, muscle, tendon, and neurovascular structures. The magnitude and often rate-limiting parameter most likely to affect the decision to attempt foot salvage is the degree of soft tissue destruction. If irreplaceable or if function cannot be restored, amputation should be considered. If reconstruction is attempted, all nonviable tissues regardless of intrinsic function must first be removed by meticulous débridement.