Treatment of chronic haematogenous osteomyelitis of the os calcis.

Twenty-five patients suffering from chronic haematogenous osteomyelitis of the os calcis were studied. The disease often presents in a subacute or chronic form, and the pathological process is well established in the majority of the cases by the time treatment is begun. For this reason, conservative treatment was found to be ineffective. Similarly, limited surgical procedures, such as curettage, sequestrectomy or partial excision, were also inadequate because of the wide-spread nature of the infection. Complete excision of the os calcis and stitching of the Achilles tendon to the plantar fascia was followed by a high rate of success, provided the other tarsal bones were not involved in the infective process. The infection was cured and reasonably normal function was obtained in 14 out of 19 patients (73.7 per cent). A "new heel" is often formed after the operation by the laying down of plaques of calcification within the toughened scar tissue of the heel pad.