Spoken by one who has some experience with feet and ankles and those missing thereof. After my PIlon fracture I underwent exactly 16 major and minor surgeries including the first emergency reconstruction effort and all subsequent efforts (fusion) , infections secondary reconstructs and fianlly an Ertl reconstuct amputation of the right lower leg. High energy trauma, if it does not kill you outright can do some meaningful long term injury to your musculoskeletal frame.