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Partial calcanectomy: an alternative to below knee amputation.

Michael Bollinger, David B Thordarson

    Foot & Ankle International
    |October 26, 2002
    PubMed
    Summary
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    Partial calcanectomy offers a successful alternative to below-knee amputation for non-healing heel wounds, including those with osteomyelitis. This surgical option leads to high patient satisfaction and wound healing, avoiding further amputation.

    Area of Science:

    • Podiatric Surgery
    • Wound Healing
    • Diabetic Foot Complications

    Background:

    • Non-healing heel wounds, often with osteomyelitis, present a significant challenge, frequently leading to below-knee amputation.
    • Conservative treatments often fail for these complex cases, necessitating alternative surgical interventions.

    Purpose of the Study:

    • To evaluate the efficacy of partial calcanectomy as a limb-sparing alternative to below-knee amputation for patients with severe heel ulcers.
    • To assess patient outcomes, including wound healing, satisfaction, pain, and functional status, following partial calcanectomy.

    Main Methods:

    • A retrospective review of 22 patients with non-healing heel wounds, with or without osteomyelitis, treated with partial calcanectomy.
    • Minimum 12-month follow-up was conducted, with an average follow-up of 27 months.

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    Main Results:

    • All 22 patients achieved wound healing, and none required a subsequent below-knee amputation.
    • Twelve patients experienced delayed wound healing, particularly those with diabetes (all 9 diabetic patients).
    • High patient satisfaction was reported, with 18 available for follow-up; functional outcomes and pain levels varied but were generally acceptable.

    Conclusions:

    • Partial calcanectomy is a viable and effective limb-sparing procedure for managing non-healing heel ulcers, even in the presence of osteomyelitis.
    • The procedure demonstrates a high level of patient satisfaction and avoids the need for below-knee amputation in this challenging patient cohort.