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Partial calcanectomy: A procedure to cherish or to reject?
A Van Riet1, R Harake, J Stuyck
1Department of Orthopaedics, University Hospital Leuven, Weligerveld 1, B-3210 Pellenberg, Belgium. annevanriet@live.be
Summary
Calcanectomy surgery can be a viable option for severe heel ulcers when conservative treatments fail, offering limb salvage and patient satisfaction despite potential complications like prolonged hospital stays and wound healing issues.
Area of Science:
- Orthopedic Surgery
- Podiatric Medicine
- Wound Care
Background:
- Large heel ulcers pose a significant risk of major limb amputation.
- Conservative treatment methods may be insufficient for complex cases.
- Partial or subtotal calcanectomy presents an alternative surgical intervention.
Purpose of the Study:
- To evaluate the efficacy of calcanectomy in limb salvage and infection eradication for large heel ulcers.
- To assess the functional outcomes and patient satisfaction following calcanectomy.
- To identify factors influencing the success and complications of calcanectomy.
Main Methods:
- A retrospective evaluation of 24 patients undergoing partial or subtotal calcanectomy.
- Assessment of limb salvage rates and infection control.
- Functional outcomes and patient satisfaction were evaluated using a questionnaire for 14 patients.
Main Results:
- Only one patient (1/24) required a below-knee amputation.
- Three patients experienced persistent wound drainage.
- Prolonged hospital stays and additional surgeries were common; recurrences were noted, particularly in patients with impaired foot sensation.
- Among 14 patients surveyed, pain was not a primary concern, and the majority reported satisfaction with the procedure, with many utilizing orthotics or external support.
Conclusions:
- Calcanectomy remains a valuable treatment option for osteitis of the calcaneus.
- The procedure demonstrates effectiveness in limb salvage and achieving patient satisfaction.
- Careful patient selection and management of potential complications are crucial for optimal outcomes.
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