Preserve the lower limb in a patient with calcaneal osteomyelitis and severe occlusive peripheral vascular disease by partial calcanectomy

Chin-Ta Lin, Chi-Yu Chen, Shyi-Gen Chen, Tim-Mo Chen, Shun-Cheng Chang

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Heel ulcers in patients with severe peripheral artery occlusive disease represent a challenge to the treating physician. They become more difficult to treat with underlying medical comorbidities. We report a case of 76-year-old man with hypertension, diabetes mellitus, and end-stage renal disease in uremia status presented to our hospital with a 3-month history of a diabetic foot ulcer on his right heel. He was diagnosed with near total artery occlusion below the knee at the local hospital, and vascular reconstruction failed. After admission, surgical debridement was performed with subsequent partial calcanectomy facilitating wound closure without tension. After surgery, the foot was immobilized with a short-leg splint for 2 weeks. Thereafter, ankle immobilization was accomplished using a thermal protective plastic splint and cast shoes with a posterior window for wound care. The wound healed well with no recurrence during the 12-month follow-up period, and the patient may return to an ambulatory status, including a normal gait pattern. In this case, we demonstrate that the partial calcanectomy is practical for the treatment of plantar heel ulcers in a patient with severe comorbidities. With proper surgical planning and postoperative care, partial calcanectomy is a viable alternative to below-the-knee amputation and may better serve the patient who would otherwise be restricted to a sedentary lifestyle. © 2014 JMS.
Original languageEnglish
Pages (from-to)74-78
Number of pages5
JournalJournal of Medical Sciences (Taiwan)
Volume35
Issue number2
DOIs
Publication statusPublished - 2015
Externally publishedYes

Keywords

  • Heel ulcer
  • Occlusive peripheral vascular disease
  • Partial calcanectomy
  • sultamicillin
  • vancomycin
  • aged
  • artery occlusion
  • Article
  • calcaneus
  • case report
  • comorbidity
  • debridement
  • diabetes mellitus
  • diabetic foot
  • drug substitution
  • drug withdrawal
  • end stage renal disease
  • follow up
  • human
  • hypertension
  • leg
  • male
  • methicillin resistant Staphylococcus aureus
  • orthopedic surgery
  • osteomyelitis
  • partial calcanectomy
  • plantar ulcer
  • uremia
  • vascular surgery
  • wound care
  • wound closure

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