Lower Extremity Function following Partial Calcanectomy in High-Risk Limb Salvage Patients

Partial calcanectomy (PC) is an established limb salvage procedure for treatment of deep heel ulceration with concomitant calcaneal osteomyelitis. The purpose of this study is to determine if a relationship exists between the amount of calcaneus removed during PC and the resulting lower extremity fu...

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Main Authors: Noah G. Oliver, John S. Steinberg, Kelly Powers, Karen K. Evans, Paul J. Kim, Christopher E. Attinger
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Journal of Diabetes Research
Online Access:http://dx.doi.org/10.1155/2015/432164
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author Noah G. Oliver
John S. Steinberg
Kelly Powers
Karen K. Evans
Paul J. Kim
Christopher E. Attinger
author_facet Noah G. Oliver
John S. Steinberg
Kelly Powers
Karen K. Evans
Paul J. Kim
Christopher E. Attinger
author_sort Noah G. Oliver
collection DOAJ
description Partial calcanectomy (PC) is an established limb salvage procedure for treatment of deep heel ulceration with concomitant calcaneal osteomyelitis. The purpose of this study is to determine if a relationship exists between the amount of calcaneus removed during PC and the resulting lower extremity function and limb salvage outcomes. Consecutive PC patients were retrospectively divided into two cohorts defined by the amount of calcaneus resected before wound closure: patients in cohort 1 retained = 50% of calcaneus, while patients in cohort 2 underwent resection of >50% of the calcaneus. The Lower Extremity Function Scale (LEFS) was used to assess postoperative lower extremity function. The average amount of calcaneus resected was 13% ± 9.2 (1–39%) and 74% ± 19.5 (51–100) in cohorts 1 and 2, respectively (P<0.0001). Below knee amputation was performed in 7 (28%) and 5 (29%) of subjects in cohorts 1 and 2, respectively (P=1.0). The average LEFS score was 33.9 ± 15.0 for subjects in cohort 1 and 36.2 ± 19.9 for the subjects cohort 2 (P=0.8257) which correlates to “moderate to quite a bit of difficulty.” Our study suggests that regardless of the amount of calcaneus resected, PC provides a viable treatment option for high-risk patients with calcaneal osteomyelitis.
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spelling doaj-art-a40a991e21424db4b7d2685e8bc0bd412025-08-20T02:20:20ZengWileyJournal of Diabetes Research2314-67452314-67532015-01-01201510.1155/2015/432164432164Lower Extremity Function following Partial Calcanectomy in High-Risk Limb Salvage PatientsNoah G. Oliver0John S. Steinberg1Kelly Powers2Karen K. Evans3Paul J. Kim4Christopher E. Attinger5Department of Plastic Surgery, Medstar Georgetown University Hospital, 3800 Reservoir Road Northwest, Washington, DC 20007, USADepartment of Plastic Surgery, Georgetown University School of Medicine, 3800 Reservoir Road Northwest, Washington, DC 20007, USADepartment of Plastic Surgery, Medstar Georgetown University Hospital, 3800 Reservoir Road Northwest, Washington, DC 20007, USADepartment of Plastic Surgery, Georgetown University School of Medicine, 3800 Reservoir Road Northwest, Washington, DC 20007, USADepartment of Plastic Surgery, Georgetown University School of Medicine, 3800 Reservoir Road Northwest, Washington, DC 20007, USADepartment of Plastic Surgery, Georgetown University School of Medicine, 3800 Reservoir Road Northwest, Washington, DC 20007, USAPartial calcanectomy (PC) is an established limb salvage procedure for treatment of deep heel ulceration with concomitant calcaneal osteomyelitis. The purpose of this study is to determine if a relationship exists between the amount of calcaneus removed during PC and the resulting lower extremity function and limb salvage outcomes. Consecutive PC patients were retrospectively divided into two cohorts defined by the amount of calcaneus resected before wound closure: patients in cohort 1 retained = 50% of calcaneus, while patients in cohort 2 underwent resection of >50% of the calcaneus. The Lower Extremity Function Scale (LEFS) was used to assess postoperative lower extremity function. The average amount of calcaneus resected was 13% ± 9.2 (1–39%) and 74% ± 19.5 (51–100) in cohorts 1 and 2, respectively (P<0.0001). Below knee amputation was performed in 7 (28%) and 5 (29%) of subjects in cohorts 1 and 2, respectively (P=1.0). The average LEFS score was 33.9 ± 15.0 for subjects in cohort 1 and 36.2 ± 19.9 for the subjects cohort 2 (P=0.8257) which correlates to “moderate to quite a bit of difficulty.” Our study suggests that regardless of the amount of calcaneus resected, PC provides a viable treatment option for high-risk patients with calcaneal osteomyelitis.http://dx.doi.org/10.1155/2015/432164
spellingShingle Noah G. Oliver
John S. Steinberg
Kelly Powers
Karen K. Evans
Paul J. Kim
Christopher E. Attinger
Lower Extremity Function following Partial Calcanectomy in High-Risk Limb Salvage Patients
Journal of Diabetes Research
title Lower Extremity Function following Partial Calcanectomy in High-Risk Limb Salvage Patients
title_full Lower Extremity Function following Partial Calcanectomy in High-Risk Limb Salvage Patients
title_fullStr Lower Extremity Function following Partial Calcanectomy in High-Risk Limb Salvage Patients
title_full_unstemmed Lower Extremity Function following Partial Calcanectomy in High-Risk Limb Salvage Patients
title_short Lower Extremity Function following Partial Calcanectomy in High-Risk Limb Salvage Patients
title_sort lower extremity function following partial calcanectomy in high risk limb salvage patients
url http://dx.doi.org/10.1155/2015/432164
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AT karenkevans lowerextremityfunctionfollowingpartialcalcanectomyinhighrisklimbsalvagepatients
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