The Vertical Contour Calcanectomy, an Alternative Approach to Surgical Heel Ulcers: A Case Series.
The Vertical Contour Calcanectomy, an Alternative Approach to Surgical Heel Ulcers: A Case Series.
- 2019
Available online through MWHC library: 2003 - present, Available in print through MWHC library:1999-2007
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.
English
1067-2516
10.1053/j.jfas.2019.04.010 [doi] S1067-2516(19)30121-8 [pii]
*Calcaneus/su [Surgery]
*Foot Ulcer/su [Surgery]
*Heel/su [Surgery]
*Orthopedic Procedures/mt [Methods]
*Postoperative Complications/ep [Epidemiology]
Aged
Aged, 80 and over
District of Columbia/ep [Epidemiology]
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Retrospective Studies
Treatment Outcome
MedStar Washington Hospital Center
Surgery/Podiatric Surgery
Journal Article
Available online through MWHC library: 2003 - present, Available in print through MWHC library:1999-2007
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.
English
1067-2516
10.1053/j.jfas.2019.04.010 [doi] S1067-2516(19)30121-8 [pii]
*Calcaneus/su [Surgery]
*Foot Ulcer/su [Surgery]
*Heel/su [Surgery]
*Orthopedic Procedures/mt [Methods]
*Postoperative Complications/ep [Epidemiology]
Aged
Aged, 80 and over
District of Columbia/ep [Epidemiology]
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Retrospective Studies
Treatment Outcome
MedStar Washington Hospital Center
Surgery/Podiatric Surgery
Journal Article