Calcanectomy as an alternative to amputation in patient with myelomeningocele

Abstract

Heel ulcers in patients with peripheral neuropathies often develop into osteomyelitis. For definitive treatment it is important to remove the infected tissue and close the skin. Total or partial calcamectomy is a good treatment option avoiding transtibial amputation. Case report of a 20-yearold patient with a history of myelomeningocele corrected at neonatal age, with walk capacity, despite severe peripheral neuropathy. It presents a heel ulcer with 4 years of evolution, submitted to several unsuccessful surgical debridments, which presents osteomyelitis of the calcaneus, with the isolation of multiple multiresistant microorganisms. Total calcamectomy was decided, with a favorable evolution and maintenance of ability to walk. Total or partial calcamectomy is a valid treatment option in patients with chronic osteomyelitis of the calcaneus, as an alternative to amputation below the knee, preventing patients from losing quality of life and walking ability without the need for orthosis. In the case reported there was a good choice of treatment without associated morbidity.