The Vertical Contour Calcanectomy, an Alternative Approach to Surgical Heel Ulcers: A Case Series

Nicole K. Cates, Kaihua Wang, Jered M. Stowers, Christopher E. Attinger, Paul J. Kim, John S. Steinberg

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)1067-1071
Number of pages5
JournalJournal of Foot and Ankle Surgery
Volume58
Issue number6
DOIs
StatePublished - Nov 2019
Externally publishedYes

Keywords

  • 4
  • below-the-knee amputation
  • calcaneal ulceration
  • functional outcomes

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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