Partial calc

Partial calcanectomy (PC) is an established limb salvage procedure for treatment of deep heel ulceration with concomitant calcaneal osteomyelitis. The purpose of this study is to determine if a relationship exists between the amount of calcaneus removed during PC and the resulting lower extremity function and limb salvage outcomes. Consecutive PC patients were retrospectively divided into two cohorts defined by the amount of calcaneus resected before wound closure: patients in cohort 1 retained = 50% of calcaneus, while patients in cohort 2 underwent resection of >50% of the calcaneus...

BACKGROUND: Below-the-knee amputations are regarded as definitive treatment for calcaneal osteomyelitis. They may be less than desirable in patients with a viable midfoot and forefoot. Partial and total calcanectomies have been reported as an alternative for limb salvage. However, the durability of the residual limb is questionable. METHODS: A systematic review was undertaken to identify material relating to the potential for limb salvage with partial or total calcanectomy in ambulatory patients with calcaneal osteomyelitis...

The treatment of calcaneal osteomyelitis in diabetic patients poses a great challenge to the treating physician and surgeon. The use of a distally based sural neurofasciocutaneous flap after an aggressive debridement of non-viable and poorly vascularized tissue and bone that is combined with a thorough antibiotic regimen provides a great technique for adequate soft tissue coverage of the heel. In this case report, the authors describe the aforementioned flap as a versatile alternative to the use of local or distant muscle flaps for diabetic patients with calcaneal osteomyelitis and concomitant large wounds...

BACKGROUND: Large ulcers on the heel often lead to major amputations. When a conservative treatment fails, a partial or subtotal calcanectomy is a possible treatment option. METHODS: 24 Patients were evaluated regarding limb salvage and infection eradication. Fourteen of these completed a questionnaire regarding functional outcome and satisfaction. RESULTS: Only 1 of 24 patients needed a below-knee amputation. Three patients did not heal and still have minor drainage of the wounds...

Partial calcanectomies are a common procedure for the treatment of chronic heel ulcers. We reviewed 50 cases from patients who had partial calcanectomies to determine what factors, if any, affect the rate of healing. Each case was followed up for 1 to 6 years after surgery. We found that calcanectomy wounds were difficult to heal, regardless of the etiology. We examined a multitude of factors to determine which ones affected the rate of closure, including body mass index, vascular status, preoperative albumin levels, wound grade, presence of methacillin-resistant Staphylococcus aureus, and other factors...

Pressure ulcers of the heel are a major and growing health-care problem. Although prevention and aggressive local wound care and pressure reduction remain the gold standard for treatment of most heel ulcers, recalcitrant wounds may require surgical intervention. Limb salvage when dealing with heel ulcers remains a challenge. Nine feet (eight patients) that underwent partial calcanectomy for chronic nonhealing heel ulcers were evaluated retrospectively. Complete healing occurred in seven of nine feet. Patients who were ambulatory before surgery remained ambulatory after healing...

Twenty-two patients with non-healing wounds over the heel, with or without underlying osteomyelitis, had been unresponsive to conservative therapy. They were treated with a partial calcanectomy as an alternative to below knee amputation. Nine patients had a primary diagnosis of diabetes. Thirteen patients had osteomyelitis from various other causes. All patients had a minimum 12 months follow-up except three who were deceased. Average follow-up was 27 months (range, two to 80 months). All patients healed their wounds with no patient requiring subsequent below knee amputation...

Chronic decubitus ulceration of the heels is a common condition encountered by podiatric physicians, especially in diabetic patients. Very often these ulcerations can progress to osteomyelitis of the calcaneus. Many times, this in turn leads to a below-the-knee amputation. A partial calcanectomy is a viable alternative to below-the-knee amputation. A more functional limb both mechanically and cosmetically is achieved, and the morbidity and mortality associated with the calcanectomy is less than with a below-the-knee amputation...