The prevalence of heel ulcers is as high as 18% in hospitalized patients. Due to lack of underlying muscle, protective fat pad, and constant pressure, poor tissue perfusion to the area inhibits healing. Concomitant comorbidities such as diabetes, neuropathy, and peripheral arterial disease provide added challenges to limb salvage. The incidence of surgical intervention in a diabetic patient with foot ulcers is 97%, with 71% going on to some form of amputation. Our study includes 10 patients with underlying calcaneal osteomyelitis who were treated with partial calcanectomy with primary flap closure and offloading pin to bar external fixation. Primary closure was achieved in 100% of patients with an average time of 106 days (ranging from 43 to 205 days), with no pin tract infections, revisional bone debridement, or subsequent BKA/AKA. Average follow-up time was 20.9 months (ranging 12 to 45 months). Partial calcanectomy with offloading pin to bar fixation allows for cost-effective fixation, accelerated healing, and a satisfying functional result in true limb salvage cases.
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