When Traditional Offloading is not an Option, Could an External Fixator be a Solution?: A Case Report

Area of Science:

• Podiatry
• Diabetology
• Orthopedic Surgery

Background:

• Diabetic plantar foot ulcers pose significant challenges in management.
• Effective offloading is crucial but often difficult due to patient factors and wound characteristics.
• Traditional offloading methods may be unsuitable for complex cases with heavy drainage or adherence issues.

Observation:

• A 61-year-old male with type 2 diabetes presented with a limb-threatening plantar foot ulcer.
• Previous offloading attempts using casts and walkers were unsuccessful due to drainage and adherence issues.
• Aggressive wound and surgical management were required.

Findings:

• An Ilizarov circular frame with a footplate was utilized for offloading and weight-bearing.
• This unconventional method was combined with negative pressure therapy.
• The treatment resulted in complete reepithelialization of the diabetic foot ulcer.

Implications:

• The Ilizarov frame offers a viable, albeit unusual, offloading solution for complex diabetic foot ulcers.
• This case highlights the potential for adapting orthopedic devices in advanced wound care.
• Successful offloading with this technique may reduce the risk of amputation in challenging diabetic foot ulcer cases.