1 Inspect the wound ^1,2

• Describe location, size and depth of the wound
• Assess and describe the nature of the wound bed, including the expected anatomical structures (soft tissue and bone), if they are damaged and to what extent. 
• Look for viability of the wound bed, including signs of necrosis, debris and signs of infection, such as swelling, erythema and purulent discharge.

Take pictures of the injury

2 Assess the vascular status of the limb^1,2

• Inspect the limb: compare the color of the limb to that of the unimpaired limb.
  Is the skin pale? Is there an expanding hematoma or continued bleeding? Or is there much less bleeding than expected, indicating insufficient circulation?
• Test the capillary refill of the skin: a pale, cold limb with slow capillary refill may suggest arterial injury and could require an emergency intervention.
• Palpate the pedal pulses if not involved in the affected area, including the popliteal artery, dorsalis pedis artery and the posterior tibial artery, which should be palpable on the dorsal side of the medial malleolus. Absence of pulses could also be caused by pre-existing conditions such as atherosclerosis.
• If in doubt, use a handheld Doppler or a CT angiogram, if available.

3 Conduct a neurological evaluation of the limb^1,2

Even simple (open) fractures with dislocations could cause nerve damage.

• Evaluation of the motor function should include testing for active movements of the toes or ankle, including dorsiflexion (common peroneal nerve), plantarflexion (tibial nerve) and eversion (superficial peroneal nerve). 
• Tendon injury or fractures may cause functional impairment without nerve damage. Try to be as specific as possible.
• Evaluate sensation based on the response to touch, examining the medial sole of the foot (medial plantar branch of the tibial nerve), the dorsum of the foot (superficial peroneal nerve) and the first web space (deep peroneal nerve).