A retrospective assessment of partial calcanectomies and factors influencing postoperative course.
Partial calcanectomies are a common procedure for the treatment of chronic heel ulcers. We reviewed 50 cases from patients who had partial calcanectomies to determine what factors, if any, affect the rate of healing. Each case was followed up for 1 to 6 years after surgery. We found that calcanectomy wounds were difficult to heal, regardless of the etiology. We examined a multitude of factors to determine which ones affected the rate of closure, including body mass index, vascular status, preoperative albumin levels, wound grade, presence of methacillin-resistant Staphylococcus aureus, and other factors. We found that the average total closure rate for patients undergoing partial calcanectomy was between 51% and 83% after 1 year, depending on various preoperative conditions. Our data suggest that even though the procedure itself is fairly straightforward, the course of recovery is complex, with a fairly high rate of failure after 1 year. We found that preoperative infections with methacillin-resistant Staphylococcus aureus, vascular disease, albumin levels, and preoperative ulcer grade had a significant bearing on the outcomes. We also identified other factors that did not seem to affect surgical outcomes. Based on these findings, the authors suggest some factors that should be considered when performing partial calcanectomies.
Cook
Jeremy
J
Beth Israel Deaconess Medical Center, Department of Surgery, Harvard Medical School, Boston, MA 02215, USA.
Cook
Emily
E
Landsman
Adam S
AS
Basile
Philip
P
Dinh
Thanh
T
Lyons
Thomas
T
Rosenblum
Barry
B
Giurini
John
J
D002111:Calcaneus / Q000601:surgery*; D017719:Diabetic Foot / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D016523:Foot Ulcer / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D009752:Nutritional Status; D016491:Peripheral Vascular Diseases / Q000150:complications; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000382:microbiology; D013530:Surgical Wound Infection / Q000382:microbiology; D014945:Wound Healing