BOFAS Abstracts Archive

You can search for abstracts by using the search bar below.
Alternatively you can browse through podium and poster presentations by selecting the year and / or type below. You can further refine your search using tags or use the search bar.

Search

RSS Abstracts 476 Expand/Collapse
- RSS 2013 64 Expand/Collapse
  - RSS Poster 24 Expand/Collapse
  - RSS Podium 40 Expand/Collapse
- RSS 2014 36 Expand/Collapse
  - RSS Podium 36 Expand/Collapse
- RSS 2015 49 Expand/Collapse
  - RSS Poster 20 Expand/Collapse
  - RSS Podium 29 Expand/Collapse
- RSS 2016 45 Expand/Collapse
  - RSS Poster 18 Expand/Collapse
  - RSS Podium 27 Expand/Collapse
- RSS 2017 40 Expand/Collapse
  - RSS Poster 15 Expand/Collapse
  - RSS Podium 25 Expand/Collapse
- RSS 2018 47 Expand/Collapse
  - RSS Poster 22 Expand/Collapse
  - RSS Podium 25 Expand/Collapse
- RSS 2019 48 Expand/Collapse
  - RSS Poster 25 Expand/Collapse
  - RSS Podium 23 Expand/Collapse
- RSS 2021 15 Expand/Collapse
  - RSS Poster 10 Expand/Collapse
  - RSS Podium 6 Expand/Collapse
- RSS 2022 46 Expand/Collapse
  - RSS Poster 23 Expand/Collapse
  - RSS Podium 23 Expand/Collapse
- RSS 2023 46 Expand/Collapse
  - RSS Poster 23 Expand/Collapse
  - RSS Podium 23 Expand/Collapse
- RSS 2024 40 Expand/Collapse
  - RSS Poster 18 Expand/Collapse
  - RSS Podium 22 Expand/Collapse

Categories: Abstracts, 2023, Podium

Long term follow-up of complex calcaneal osteomyelitis treated with modified Gaenslen approach

A. Kendal, B. Down, C. Loizou, M. McNally

¹Nuffield Orthopaedic Centre, Oxford, United Kingdom

Background: The treatment of chronic calcaneal osteomyelitis is a challenging and increasing problem because of the high prevalence of diabetes mellitus and operative fixation of heel fractures. In 1931, Gaenslen reported treatment of hematogenous calcaneal osteomyelitis by surgical excision through a midline, sagittal plantar incision. We have refined this approach to allow successful healing and early mobilization in a modern series of complex patients with hematogenous, diabetic, and postsurgical osteomyelitis.

Methods: Twenty-eight patients (mean age 54.6 years, range 20-94) with Cierny-Mader stage IIIB chronic osteomyelitis were treated with sagittal incision and calcaneal osteotomy, excision of infected bone, and wound closure. All patients received antibiotics for at least 6 weeks, and bone defects were filled with an antibiotic carrier in 20 patients. Patients were followed for a mean of 31 months (SD 25.4). Primary outcome measures were recurrence of calcaneal osteomyelitis and below-knee amputation. Secondary outcome measures included 30-day postoperative mortality and complications, duration of postoperative inpatient stay, footwear adaptions, mobility, and use of walking aids.

Results: All 28 patients had failed previous medical and surgical treatment. Eighteen patients (64%) had significant comorbidities. The commonest causes of infection were diabetes ± ulceration (11 patients), fracture-related infection (4 patients), pressure ulceration, hematogenous spread, and penetrating soft tissue trauma. The overall recurrence rate of calcaneal osteomyelitis was 18% (5 patients) over the follow-up period, of which 2 patients (7%) required a belowknee amputation. Eighteen patients (64%) had a foot that comfortably fitted into a normal shoe with a custom insole. A further 6 patients (21%) required a custom-made shoe, and only 3 patients required a custom-made boot.

Conclusion: Our results show that a repurposed Gaenslen calcanectomy is simple, safe, and effective in treating this difficult condition in a patient group with significant local and systemic comorbidities.

Print

Tags: Infection Salvage Calcaneus

Documents to download

Long term follow-up of complex calcaneal osteomyelitis treated with modified Gaenslen approach(.pdf, 652.03 KB) - 424 download(s)

Click thumbnail below to view poster / thumbnail:

Archive of Abstracts