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Gaenslen's split-heel incision for calcaneal osteomyelitis--case report
J Terrence Jose Jerome1, Simon Thomas
1Department of Orthopedics, St Stephen's Hospital, Tiz Hazari, Delhi 54, India. terrencejose@gmail.com
Foot (Edinburgh, Scotland)
|March 24, 2010
Summary
Gaenslen's split-heel incision effectively treated chronic calcaneal osteomyelitis with non-healing ulcers. This surgical technique resulted in a painless, deeply situated scar, avoiding amputation and promoting remarkable wound healing.
Area of Science:
- Orthopedic Surgery
- Wound Healing
- Infectious Diseases
Background:
- Chronic osteomyelitis of the calcaneum presents challenges, often leading to non-healing ulcers and recurrent infections.
- Standard treatments may fail, necessitating advanced surgical interventions to prevent lower extremity amputation.
Observation:
- A 45-year-old female patient presented with chronic calcaneal osteomyelitis, a large non-healing ulcer, and a discharging sinus.
- Recurrent heel ulcers pose a significant risk for below-the-knee amputation due to inadequate soft tissue coverage.
Findings:
- Gaenslen's split-heel incision technique was employed, involving dividing the calcaneum to access and debride infected bone and tissue.
- The procedure successfully removed sequestra and infected material with minimal cortical damage.
- Remarkable wound healing was observed within six weeks, characterized by a deeply situated, painless scar.
Implications:
- Gaenslen's technique offers a viable solution for refractory calcaneal osteomyelitis and chronic heel ulcers, potentially preventing amputation.
- The resulting 'cushioning' effect of the scar tissue provides durable coverage and functional improvement.
- This approach highlights the importance of specialized surgical methods for complex foot and ankle infections.
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