Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015:2015:432164.
doi: 10.1155/2015/432164. Epub 2015 Jan 27.

Lower extremity function following partial calcanectomy in high-risk limb salvage patients

Noah G Oliver  1 , John S Steinberg  2 , Kelly Powers  3 , Karen K Evans  2 , Paul J Kim  2 , Christopher E Attinger  2
Affiliations

Lower extremity function following partial calcanectomy in high-risk limb salvage patients

Noah G Oliver et al. J Diabetes Res. 2015.

Abstract

Partial calcanectomy (PC) is an established limb salvage procedure for treatment of deep heel ulceration with concomitant calcaneal osteomyelitis. The purpose of this study is to determine if a relationship exists between the amount of calcaneus removed during PC and the resulting lower extremity function and limb salvage outcomes. Consecutive PC patients were retrospectively divided into two cohorts defined by the amount of calcaneus resected before wound closure: patients in cohort 1 retained = 50% of calcaneus, while patients in cohort 2 underwent resection of >50% of the calcaneus. The Lower Extremity Function Scale (LEFS) was used to assess postoperative lower extremity function. The average amount of calcaneus resected was 13% ± 9.2 (1-39%) and 74% ± 19.5 (51-100) in cohorts 1 and 2, respectively (P < 0.0001). Below knee amputation was performed in 7 (28%) and 5 (29%) of subjects in cohorts 1 and 2, respectively (P = 1.0). The average LEFS score was 33.9 ± 15.0 for subjects in cohort 1 and 36.2 ± 19.9 for the subjects cohort 2 (P = 0.8257) which correlates to "moderate to quite a bit of difficulty." Our study suggests that regardless of the amount of calcaneus resected, PC provides a viable treatment option for high-risk patients with calcaneal osteomyelitis.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Heel ulcer with osteomyelitis.
Figure 2
Figure 2
Category 2 partial calcanectomy.
Figure 3
Figure 3
Category 1 partial calcanectomy: ≤50% resected.
Figure 4
Figure 4
Category 2 partial calcanectomy: >50% resected.
Figure 5
Figure 5
Category 1 partial calcanectomy.
Figure 6
Figure 6
Category 2 partial calcanectomy.
See this image and copyright information in PMC

References

    1. Smith D. G., Stuck R. M., Ketner L., Sage R. M., Pinzur M. S. Partial calcanectomy for the treatment of large ulcerations of the heel and calcaneal osteomyelitis. An amputation of the back of the foot. The Journal of Bone and Joint Surgery Series A. 1992;74(4):571–576. - PubMed
    1. Schade V. L. Partial or total calcanectomy as an alternative to below-the-knee amputation for limb salvage: a systematic review. Journal of the American Podiatric Medical Association. 2012;102(5):396–405. doi: 10.7547/1020396. - DOI - PubMed
    1. Goudie E. B., Gendics C., Lantis J. C., II Multimodal therapy as an algorithm to limb salvage in diabetic patients with large heel ulcers. International Wound Journal. 2012;9(2):132–138. doi: 10.1111/j.1742-481x.2011.00869.x. - DOI - PMC - PubMed
    1. Faglia E., Clerici G., Caminiti M., Curci V., Somalvico F. Influence of osteomyelitis location in the foot of diabetic patients with transtibial amputation. Foot and Ankle International. 2013;34(2):222–227. doi: 10.1177/1071100712467436. - DOI - PubMed
    1. Barczak C. A., Barnett R. I., Childs E. J., Bosley L. M. Fourth national pressure ulcer prevalence survey. Advances in Wound Care. 1997;10(4):18–26. - PubMed

MeSH terms

LinkOut - more resources