Early Clinical, Functional, and Mortality Outcomes for Heel Ulcers Treated With a Vertical Contour Calcanectomy

Area of Science:

• Podiatric Surgery
• Orthopedic Surgery
• Wound Healing

Background:

• Heel ulcerations are common in patients with diabetes, peripheral vascular disease, and immobility.
• Calcaneal osteomyelitis associated with heel ulcers increases amputation risk and limits treatment options.
• Conventional therapies are often insufficient for complex, recalcitrant heel ulcerations.

Purpose of the Study:

• To evaluate the outcomes of the novel Vertical Contour Calcanectomy (VCC) procedure.
• To provide guidance based on objective findings from VCC interventions.
• To report the largest series of VCC outcomes at one year.

Main Methods:

• Retrospective analysis of 51 patients undergoing VCC for heel ulcerations.
• Surgical technique involves wide soft tissue excision and defined calcaneal bone cuts.
• Outcomes assessed at 1-year follow-up, including healing, recurrence, amputation, mortality, and function.

Main Results:

• 31.4% of patients achieved complete healing without recurrence, amputation, or mortality at 1 year.
• The overall limb salvage rate post-VCC was 68.6% at one year.
• 79.3% of patients reported similar or improved function compared to their perioperative state.
• All-cause mortality at one year was 9.8%.

Conclusions:

• Vertical Contour Calcanectomy (VCC) is a viable surgical option for complex heel ulcerations, offering limb salvage and functional improvement.
• The VCC procedure, involving debridement and bone resection, can reduce bioburden and facilitate soft tissue closure.
• While not curative for all, VCC demonstrates potential in managing challenging cases, with a significant limb salvage rate and functional recovery observed.