Enhancing Wound Perfusion in High-Risk Lower Extremity Orthopaedic Surgery: A Study on Nitropaste Using Intraoperative SPY Imaging.

Inclusion Criteria: * Adults aged 18 years or older. * Undergoing surgery for one of the following procedures: * Current Procedural Terminology (CPT) 28415 - Open reduction calcaneal fracture ± internal/external fixation * CPT-27814 - Open reduction of bimalleolar fracture ± internal/external fixation * CPT-27822 - Open reduction trimalleolar ankle fracture, medial and lateral malleoli only, ± internal/external fix * CPT-27823 - Open reduction trimalleolar ankle fracture, including posterior malleolus, ± internal/external fix * CPT-27826 - Open reduction pilon fracture, internal/external fixation of fibula ONLY * CPT-27827 - Open reduction pilon fracture, internal/external fixation of tibia ONLY * CPT-27828 - Open reduction pilon fracture, internal/external fixation of tibia AND fibula * CPT-27535 - Open reduction unicondylar tibial plateau fracture, ± internal/external fixation * CPT-27536 - Open reduction bicondylar tibial plateau fracture, ± internal/external fixation * CPT-28445 - Open reduction of talus fracture, ± internal/external fixation * CPT-27650 - Primary Achilles tendon repair * English-speaking * Able to provide informed consent during preoperative clinic visit, in the preoperative nursing area, or on inpatient units. Exclusion Criteria: * Contraindications to nitroglycerin, including known allergy. * Allergy to indocyanine green or components of ICG dye, including allergies to iodine or shell-fish. * Severe kidney injury, as determine…