Characteristics of calcaneal osteomyelitis: an unusual and severe form of diabetic foot disease

Grecian, Sheila; Chadwick, Paul; Haycocks, Samantha; Chadwick, Paul; Young, Robert J.; Paisley, Angela

doi:10.15277/bjdvd.2015.042

Cited by 2 publications

(3 citation statements)

References 9 publications

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“…In this study, five patients with calcaneal osteomyelitis had delayed healing time in this study (141.20 ± 19.12 vs 124.69 ± 14.42). Paisley et al have reported a 33% healing rate at 30 weeks in diabetic heel ulceration with calcaneal osteomyelitis in comparison to 94% in those without osteomyelitis 34 …”

Section: Discussionmentioning

confidence: 99%

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An novel and alternative treatment method for large heel ulceration in diabetic patients: Proximal tibial cortex transverse distraction

Xu¹,

Bai

Peng

et al. 2022

International Wound Journal

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Heel ulceration in patients with diabetes mellitus (DM) is a major clinical challenge, manifesting with a protracted and uncertain healing process. The prefer treatment of heel ulceration is still controversial. This study aims at describing a newly alternative surgical method with the proximal transverse tibial bone transport technique, as an attempt to achieve wound healing in diabetic patients with large heel ulceration. Retrospective clinical study. A total of 21 diabetic patients with large heel ulceration were enrolled and followed up at least 6 months. The following parameters were assessed: Visual analogue scale (VAS), healing time, ulcer healing rate, ulcer recurrence rate and limb salvage rate. All patients got fully follow‐up and achieved wound healing uneventfully. Eighteen patients returned to independent walking without any helper while three patients walked using a crutch. Limb salvage was achieved in all 21 patients (100%). The mean wound area was 67.43 ± 13.31 cm2 (range: 46‐97 cm2). The mean healing time was 128.62 ± 16.76 days (range: 91‐160 days). 16 out of 21 patients without calcaneal osteomyelitis achieved ulcer healing with a mean duration of 124.69 ± 14.42 days (range: 91–143 days), while the other five patients with calcaneal osteomyelitis were 141.20 ± 19.12 days (range: 110‐160 days). 2 out of 21 patients got superficial rupture at the previous wounds and healed after outpatient dressing change combined with oral antibiotics. The novel technique described is particularly applicable for large heel ulceration in diabetic patients. It offers a better alternative for achieving wound healing with a favourable encouraging outcome.

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Section: Discussionmentioning

confidence: 99%

“…Paisley et al have reported a 33% healing rate at 30 weeks in diabetic heel ulceration with calcaneal osteomyelitis in comparison to 94% in those without osteomyelitis. 34 …”

Section: Discussionmentioning

confidence: 99%

An novel and alternative treatment method for large heel ulceration in diabetic patients: Proximal tibial cortex transverse distraction

Xu¹,

Bai

Peng

et al. 2022

International Wound Journal

View full text Add to dashboard Cite

show abstract

“…Paisley et al have reported a 33% healing rate at 30 weeks in those with diabetic calcaneal osteomyelitis in comparison to 94% healing in those with heel ulceration without osteomyelitis. 14 Treatment usually demands resection of a key weight bearing area of the tuberosity within the proximity of Achilles tendon insertion. Earlier studies have reported varying healing rates from 35% to 74%.…”

Section: Introductionmentioning

confidence: 99%

Medium-term outcomes of multi-disciplinary surgical management of non-ischemic diabetic heel ulcers

Phyo

Tang

Kavarthapu

2021

Journal of Clinical Orthopaedics and Trauma

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Background: Heel ulcers in patients with peripheral neuropathy and diabetes pose a significant challenge to treating physicians. Infection spreading to the os calcis is associated with a poor prognosis. There is no consensus on which method of surgical treatments results in better outcomes. The aim of this study was to assess patients' survival, rate of ulcer healing following surgical treatment, along with limb salvage rate, time taken for healing, ulcer recurrence and patients' functional outcome after healing. Methods: We studied 29 patients (20 men, 9 women) presenting with diabetic neuropathic heel ulcers (30 feet) and no critical limb ischemia, were managed surgically in our unit and followed-up for a minimum of 12 months. We assessed their clinical and functional outcomes within a mean follow-up period of 28 months (12e83). Results: 11 out of 29 patients died (38%) with mean duration of post op survival being 31months (range 4 e70). 14 ulcers (50%) healed fully within a mean of 360 days (131e1676). Limb salvage was achieved in 29 feet (97%). Only 5 out of 17 patients with diabetic nephropathy (p value 0.016) and 9 out of 24 ulcers with calcaneal osteomyelitis (p value 0.044) achieved full ulcer healing. Ulcer recurrence rate was 36% (5/ 14) within 12 months of achieving ulcer healing. Six patients were able to return to independent walking in surgical shoes while 11 patients were mobilising using either a crutch or frame. Conclusion: While excellent limb salvage can be anticipated from the outcome of surgically managed infected heel ulcers in patients with diabetes, complete healing can still be slow and unpredictable. Significant medical co-morbidities in these patients make them vulnerable to medium-term postoperative complication and survival.

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Characteristics of calcaneal osteomyelitis: an unusual and severe form of diabetic foot disease

Cited by 2 publications

References 9 publications

An novel and alternative treatment method for large heel ulceration in diabetic patients: Proximal tibial cortex transverse distraction

An novel and alternative treatment method for large heel ulceration in diabetic patients: Proximal tibial cortex transverse distraction

Medium-term outcomes of multi-disciplinary surgical management of non-ischemic diabetic heel ulcers

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