Limb salvage by excision of calcaneus in diabetic atherosclerotic gangrene
Teleki, B.áz.; Ungár, D.én.; Horánszky, Z.án.; Kalocsai, L.ás.ó
Magyar Sebeszet 57(1): 43-46
2004
ISSN/ISBN: 0025-0295 PMID: 15270522 Document Number: 572558
We treated a 49-year-old female patient, who developed diabetic, arteriosclerotic gangrene. Only after the extensive wet gangrene extended to the proximal half sole, she was finally consenting to surgery, and a femoropopliteal Dacron bypass graft was performed. The area of the osteomyelitic calcaneus was removed by necrectomy (slough cutting) but the calcaneus fractured spontaneously after two weeks. Therefore the calcaneus was excised and the half-sole defect was covered by the available skin of the posterior heel and forefoot region. The wound required meticulous local treatment for two months. She has been able to walk without a frame using an orthopedic shoe fitted with a total contact insole with proper lifting of the heel region. Our aim was limb saving and recovery favourable to crural amputation, which could have been justified in such extensive gangrene. We would like to highlight to the possibility of the excision of the calcaneus, as no data has been found about it in the Hungarian literature. Walking after the excision of the calcaneus is possible with the help of a specially developed orthopaedic shoe, properly fitted with a total contact insole.