[Osteomyelitis in diabetic foot: reconstruction with autologous bone graft]

Moderate to severe infections in the diabetic foot (DF), such as osteomyelitis, frequently require surgical intervention and prolonged antibiotic therapy. Amputation is often unavoidable, with high morbidity and mortality rates in the initial years. Bone resection can lead to deformities and loss of foot function, introducing further complications. This report presents a case of a 45-year-old patient with type 2 Diabetes Mellitus (DM) and osteomyelitis in the first ray, managed through surgical debridement, an antibiotic-loaded cement spacer, and vacuum-assisted closure (VAC) to control infection, along with a six-week antibiotic treatment. Following favorable clinical progress and normalization of inflammatory markers, a second-stage surgical reconstruction was performed using autologous bone grafting and metatarsophalangeal arthrodesis with internal fixation to preserve the length and functionality of the first ray. The patient demonstrated positive outcomes over the next 40 months, with no recurrence of infection.