Total calcanectomy in chronic osteomyelitis of calcaneus: A case report

Chronic osteomyelitis of the calcaneus, although uncommon, is associated with substantial morbidity and remains one of the most challenging forms of chronic osteomyelitis to treat, causing significant patient morbidity. The condition is rather refractory to various treatment modalities and sometimes may necessitate below-knee amputation for complete eradication of infection. Total calcanectomy, in such a scenario, can be a limb salvage (foot salvage) procedure in carefully selected patients. Here we report a case of Cierny-Mader stage IV chronic osteomyelitis of the calcaneus treated by means of total calcanectomy and application of antibiotic (vancomycin and gentamicin) impregnated beads of synthetic absorbable calcium sulfate powder (STIMULAN, Biocomposites, UK), with a follow-up period of 6 years and 2 months - complete eradication of infection while preserving the weight-bearing functions of foot, has been successfully achieved. To our knowledge, this is among the first few reported cases of total calcanectomy combined with application of synthetic absorbable antibiotic-loaded calcium sulphate (STIMULAN) beads for chronic diffuse calcaneal osteomyelitis.