Surgical Management of Cleft Defects Following Central Ray Amputations

Neuropathic ulcerations are a common complication in patients with diabetes mellitus. Failure to manage diabetic foot ulcers can lead to devastating consequences in this patient population. There are a variety of approaches that the clinician and surgeon alike can take to prevent morbidity and mortality in patients with diabetic foot ulcers. Likewise, providers are constantly searching for new ways to help improve patient outcomes. We present an innovative technique in the management of cleft wound defects that are common in central ray foot amputations. The case involves a 66-year-old, type 2 diabetic male presenting to the emergency department with an infected diabetic foot ulcer to the central metatarsal heads. Our technique of combining external fixation with advanced wound care products offered this patient a stable, plantigrade, and ulcer-free foot at 1-year follow-up.