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Calcanectomy, an alternative amputation? Two case reports
Jan H B Geertzen1, Paul Jutte, Christiaan Rompen
1Center for Rehabilitation and Graduate School for Health Research, University Medical Center Groningen, Groningen, The Netherlands. j.h.b.geertzen@rev.umcg.nl
Abstract:
A limb amputation is a traumatic experience for the amputee but it is also a challenge for the recipient to get used to a new situation and reach her/his greatest level of independence. Two patients are presented who had undergone a total calcanectomy. In the first case, a woman with spina bifida aperta L4-L5, calcanectomy was performed to excise a non-healing ulcer and osteomyelitis of the right heel. In the second case, a woman of 72 years of age, calcanectomy was the treatment of the isolated central chondrosarcoma. Both patients were somewhat disabled prior to calcanectomy, one because of spina bifida aperta and the other because of her age. After calcanectomy both patients were able to remain independent for several years. Calcanectomy is an uncommon amputation that may provide better quality of life than other more proximal amputations such as Syme or transtibial amputation. Furthermore more proximal levels of amputation are associated with increased mortality and morbidity. When indicated, calcanectomy should be considered as an alternative type of amputation which provides an effective chance to maintain the patient's independency.