Partial Calcanectomy as an Alternative to Below the Knee Amputation for Limb Salvage in Infected Heel Ulcer with Osteomyelitis
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- Category: Vol. 90, December 2022
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Partial Calcanectomy as an Alternative to Below the Knee Amputation for Limb Salvage in Infected Heel Ulcer with Osteomyelitis, HASSAN HATEM M.N.M.M. MOKHTAR, MOHY AL-DEEN AL-BANNA, AYMAN ABD EL-FATTAH, KARIM Sh.M. EL-AWADY and AMR ABDELGHAFFAR H. MAHMOUD
Abstract
Background: Amputations above the ankle level are usually the gold standard procedure for severe calcaneal osteomyelitis. Partial calcanectomy have been advocated as viable alternatives to below knee amputation. It aimed to limb salvage with subsequent decrease morbidity, mortality and improve quality of life Patients and Methods: A prospective single arm cohort study conducted on 20 patients between 2020 to 2022 at single center, Ain Shams University Hospitals, Patients had infected heel ulcers with osteomyelitis and Partial Calcanectomy was performed to them, then follow-up of the wounds was done. Results: No postoperative complication or signs of ischemia 15 males (75%) and 5 females (25%). The age ranged between 51 years and 73 years with mean age of 63±7. Most of patients are diabetic (90%), hypertensive (85%), 2/3 of them were smoker. Limb salvage was achieved on 65 % of cases with no recorded 30 day mortality All cases had score 4 WIFI classification and there were no sever limb ischemia. Subgroups difference in wound depth, degree of foot infection and ankle brachial index may have impact on limb salvage. (ABI), achieved in 3 cases after 1 month, 7 cases after 3 month and 3 cases after 7 months. Conclusion: Partial calcanectomy is safe and effective alternative to below knee amputation in treatment of heel ulcer and calcaneal osteomyelitis.