Abstract
Heel ulcers have a significant impact on lower-extremity morbidity and confer high
risk of major amputations. Treating these ulcers is difficult because of poor tissue
coverage and the bony os calcis, often leading to proximal amputation. This case series
shows the vertical contour calcanectomy (VCC) as a surgical alternative in functional
limb salvage. Sixteen feet (14 patients) with recalcitrant heel wounds who underwent
VCC were identified. The minimum follow-up time for inclusion was 1 year. Body mass
index, diabetes, renal disease, peripheral vascular disease, lymphedema/venous insufficiency,
smoking status, Charcot, amputation, vascular intervention, wound recurrence, reoperation
rate, and ambulatory status were evaluated. The average follow-up time was 27.1 months
(range 13.5 to 51.1). At 1 year of follow-up, 56% of heel wounds (9 of 16) treated
with the VCC remained closed. An average of 1.44 subsequent surgeries were required
per patient. Baseline or improved ambulatory status was achieved in 69% of patients
(9 of 14) at 1-year follow up and 100% of patients (8 of 8) at 2-year follow up. The
overall rate of major amputation was 19%. The long-term ambulatory status of patients
treated with the VCC shows promise. The VCC should be considered as an alternative,
reliable, surgical limb salvage tool for heel ulcerations.
Clinical Level of Evidence
Keywords
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Article info
Footnotes
Financial Disclosure: This study was supported by the Department of Plastic Surgery, MedStar Georgetown University Hospital.
Conflict of Interest: None reported.
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