[Surgical approach to a leg ulcer in areas of subcutaneous calcinosis]

The medical treatment of ulceration of the legs in areas with a subcutaneous plaque of calcinosis is often unsuccessful. The phlebologists then refer the patient to a surgeon. A patient aged 58 years, with a previous history of phlebitis, presented on two successive occasions with ulceration in the area of a large calcification in the lower third of the left leg. Cicatrization was obtained by a surgical treatment. Such surgery must be preceded by local and complete vascular assessment and by appropriate pre-operative care. It consists mainly of ablation of bone sequestration in order to obtain a suitable surface on which to apply thin skin graft in strips. It is often necessary to carry out an internal saphenous crossectomy as well to treat an associated venous insufficiency.