Patient History
Patient is a 52-year-old male with a history of right foot diabetic Charcot neuroarthropathy and progressive collapse. He has an extensive surgical history of metatarsal amputation as well as multiple surgeries to correct the persisting deformity and foot ulceration. He presented to the clinic with a large plantar ulcer across ~30% of the bottom of his foot with drainage persisting for over one year.
Treatment
Examination revealed complete loss of protective sensation, a lateral ulcer with exposed lateral malleolus, and purulent drainage. Imaging demonstrated severe Charcot deformity as well as osteomyelitis of the talar remnant with a deep abscess.
A BKA was performed where the transverse bone was resected ~11cm below the tibial tubercle. Restrata Sheet was fenestrated and applied superficially to the fascial closure. It was then closed over to reinforce the subcutaneous layer of tissue, helping to mitigate the possibility of dehiscence or suture line breakdown.