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Partial calcanectomy in high-risk patients with diabetes: use and utility of a "hurricane" incisional approach
Timothy K Fisher1, David G Armstrong
1Southern Arizona Limb Salvage Alliance, Department of Surgery, University of Arizona College of Medicine, 1501 N Campbell Ave, Tucson, AZ 85724, USA.
Introduction:
Plantar heel ulcers in people with diabetes represent a difficult challenge to the treating physician. They become even more difficult with underlying osteomyelitis. When this infection is in the calcaneus it typically results in a partial or total calcanectomy or even more frequently, high-level amputation.
Methods:
In this article, we describe a novel serpentine incisional approach to the plantar and (if necessary) posterior heel allowing for ample exposure and facilitating closure predominantly along relaxed skin tension lines.
Results:
We present several representative case examples in which a hurricane incision has been used to treat and provide closure to plantar-based calcaneal ulcers.
Discussion:
The use of this incision, which resembles a satellite view of a hurricane, was successful in achieving a desired partial calcanectomy and wound closure. This may be an additional tool in the armamentarium of the surgeon to assist in healing and amputation prevention.
