Abstract
Chronic nonhealing heel ulcerations have been established as an independent risk factor
for major amputation, with poor rates of limb salvage success. Partial calcanectomy
is a controversial limb salvage procedure reserved for patients with these heel ulcerations.
We conducted a retrospective cohort study reviewing 39 limbs that underwent a partial
calcanectomy from 2012 to 2018 to evaluate the proportion of patients healed, time
to healing, ulcer recurrence, and postoperative functional level compared to the preoperative
state. In addition, age, gender, body mass index, smoking status, coronary artery
disease, diabetes mellitus, renal insufficiency, dialysis, peripheral arterial disease,
method of closure, and percent of calcaneus resected were evaluated. Mean follow-up
for our cohort was 2.3 years. We had a 1 year mortality rate of 11%, and a major amputation
rate of 18%. Our results demonstrated a 77% healing rate with a median time to healing
of 162 days. We found that patients who were closed primarily had a faster time to
healing compared to patients who underwent closure by secondary intention. Our data
showed that ulcer recurrence developed in 57% of healed limbs. We found that 76% of
our patients were ambulatory postoperatively. These results suggest that partial calcanectomy
is a viable limb salvage procedure with a predictable level of ambulation and function
in a high-risk patient population.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: September 14, 2022
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
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© 2022 by the American College of Foot and Ankle Surgeons. All rights reserved.
