Partial calcanectomy in high-risk patients with diabetes: use and utility of a "hurricane" incisional approach.

INTRODUCTION

Plantar heel ulcers in people with diabetes represent a difficult challenge to the treating physician. They become even more difficult with underlying osteomyelitis. When this infection is in the calcaneus it typically results in a partial or total calcanectomy or even more frequently, high-level amputation.

METHODS

In this article, we describe a novel serpentine incisional approach to the plantar and (if necessary) posterior heel allowing for ample exposure and facilitating closure predominantly along relaxed skin tension lines.

RESULTS

We present several representative case examples in which a hurricane incision has been used to treat and provide closure to plantar-based calcaneal ulcers.

DISCUSSION

The use of this incision, which resembles a satellite view of a hurricane, was successful in achieving a desired partial calcanectomy and wound closure. This may be an additional tool in the armamentarium of the surgeon to assist in healing and amputation prevention.