Partial calcanectomy: A procedure to cherish or to reject?

BACKGROUND: Large ulcers on the heel often lead to major amputations. When a conservative treatment fails, a partial or subtotal calcanectomy is a possible treatment option.

METHODS: 24 Patients were evaluated regarding limb salvage and infection eradication. Fourteen of these completed a questionnaire regarding functional outcome and satisfaction.

RESULTS: Only 1 of 24 patients needed a below-knee amputation. Three patients did not heal and still have minor drainage of the wounds. However, hospital stay was long and in many cases additional surgery was necessary. Recurrences are seen, especially in patients with impaired sensation of the foot. In the fourteen patients who completed the questionnaire, pain was not a major problem. Many patients use orthotics and external support. The majority, however, is satisfied with the procedure and would consider the same treatment again.

CONCLUSION: Calcanectomy still has a place in the treatment of osteitis of the calcaneus.