Partial and total calcanectomy: a review of thirty-one consecutive cases over a ten-year period.

From 1968 to 1978 we performed twenty partial and eleven total calcanectomies in twenty-nine patients, eighteen of whom were diabetics with ulcerations of the heel. All but two had osteomyelitis of the calcaneus. Eight of the patients had an injury of the spine. The remaining patients had conditions in which sensation in the heel was absent or decreased. In about one-half of the diabetic patients, immediate failure of the procedure led to amputation. Primary wound-healing occurred in only four of the eighteen diabetics, but in the non-diabetic patients ten of the thirteen heels showed primary healing. Late failure also occurred in three diabetic patients. The overall rate of failure in the diabetics was 65%.