TY  - BOOK
AU  - Cates, Nicole K
AU  - Steinberg, John S
AU  - Stowers, Jered M
AU  - Wang, Kaihua
TI  - The Vertical Contour Calcanectomy, an Alternative Approach to Surgical Heel Ulcers: A Case Series
SN  - 1067-2516
PY  - 2019///
KW  - *Calcaneus/su [Surgery]
KW  - *Foot Ulcer/su [Surgery]
KW  - *Heel/su [Surgery]
KW  - *Orthopedic Procedures/mt [Methods]
KW  - *Postoperative Complications/ep [Epidemiology]
KW  - Aged
KW  - Aged, 80 and over
KW  - District of Columbia/ep [Epidemiology]
KW  - Female
KW  - Follow-Up Studies
KW  - Humans
KW  - Incidence
KW  - Male
KW  - Middle Aged
KW  - Retrospective Studies
KW  - Treatment Outcome
KW  - MedStar Washington Hospital Center
KW  - Surgery/Podiatric Surgery
KW  - Journal Article
N1  - Available online through MWHC library: 2003 - present, Available in print through MWHC library:1999-2007
N2  - 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. Copyright (c) 2019 the American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved
UR  - https://dx.doi.org/10.1053/j.jfas.2019.04.010
ER  -