Two-staged hindfoot reconstruction with vascularized fibula graft for calcaneal osteomyelitis caused by methicillin-resistant Staphylococcus aureus: a case report.
Hindfoot reconstruction after calcaneal osteomyelitis is a challenging procedure designed to restore the weight bearing function of the heel and to allow a functional reconstruction of the Achilles tendon. Some patients require subtalar arthrodesis after primary calcaneal osteosyntesis or hindfoot reconstruction due to the considerable pain associated with weight-bearing caused by the irregular surface of the subtalar joint. To date, no reports have shown a case of hindfoot reconstruction with subtalar arthrodesis using a pedicled vascularized fibula graft. We report a case of a 24-year-old woman who presented with calcaneal methicillin-resistant Staphylococcus aureus osteomyelitis after open comminuted fracture due to a fall. Radical debridement of bone and soft tissue was repeated six times in combination with negative pressure wound therapy, followed by hindfoot reconstruction with pedicled vascularized fibula and subtalar arthrodesis. Good functional restoration had been achieved by the final follow-up 18 months after surgery.
Department of Orthopaedic Surgery, Numazu City Hospital, 550 Higashi-shiiji, Numazu, Shizuoka, 410-0302, Japan. orthopaedics@hotmail.co.jp
Jun
J
Endo
Kazuki
K
Kuniyoshi
Makondo
M
Mochizuki
Katsuhito
K
Shimoyama
Tadaaki
T
Koyama
Atsuomi
A
Aiba
Ryo
R
Kadota
Yasuhito
Y
Sasaki
D002111:Calcaneus / Q000601:surgery*; D005260:Female; D005360:Fibula / Q000098:blood supply* / Q000637:transplantation*; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus; D010019:Osteomyelitis / Q000382:microbiology* / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013203:Staphylococcal Infections / Q000601:surgery*; D055815:Young Adult