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A Case of Chronic Limb-Threatening Ischemia with Heel Ulcers Cured by Revascularization and Partial Calcanectomy

Takamitsu Tatsukawa1, Shinsuke Kikuchi1, Ai Tochikubo1

  • 1Department of Vascular Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.

Annals of Vascular Diseases
|April 11, 2020
PubMed

Insights

This case study shows that partial calcanectomy (PC) can effectively heal chronic, infected heel ulcers in patients with critical limb ischemia. Combining PC with bypass surgery offers a viable limb salvage option.

Area of Science:

  • Vascular Surgery
  • Podiatric Surgery
  • Wound Healing

Background:

  • Chronic limb-threatening ischemia frequently leads to infected heel ulcers, posing significant salvage challenges.
  • Bilateral heel ulcers in an 82-year-old patient complicated by chronic ischemia highlight the severity of the condition.

Purpose of the Study:

  • To present a case demonstrating the successful management of bilateral ischemic heel ulcers.
  • To evaluate the efficacy of combining bypass surgery with partial calcanectomy (PC) for limb salvage.

Main Methods:

  • The patient underwent femoral-terminal posterior tibial artery bypass surgery for right limb ischemia.
  • Right calcaneus osteomyelitis was treated with partial calcanectomy (PC).
  • Left foot ulcer also healed after distal bypass and PC.

Main Results:

  • The right heel ulcer healed completely six months post-bypass surgery and PC.
  • The left foot ulcer also achieved healing following similar treatment.
  • Successful limb salvage was achieved for both feet.

Conclusions:

  • Partial calcanectomy (PC) is a crucial intervention for healing infected heel ulcers in ischemic limbs.
  • The combined approach of bypass surgery and PC offers a successful limb salvage strategy for complex cases.

Keywords:
calcaneus osteomyelitisheel ulcerperipheral artery disease

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