case_images: PMC3284307_01
case_images: (A) Preoperative picture of the left calcaneal osteomyelitis with the large wound at initial presentation. (B) Preoperative angiography showing the popliteal artery occlusion.
case_images: DFA-1-5544-g001.jpg
case_images: PMC3284307_01_DFA-1-5544-g001.jpg
case_images: F0001
case_images: The patient had a history of smoking for many years and also sustained a calcaneal osteomyelitis secondarily to the original infection with Staphylococcus aureus and Pseudomonas aeruginosa organisms (Fig. 1A). In our facility, the patient had immediate non-invasive vascular studies that were followed with a lower extremity angiography that showed a vascular occlusion of the popliteal artery around the popliteal fossa (Fig. 1B).
case_images: (A) Intraoperative picture showing harvesting of the large sural pedicle flap to cover the calcaneal resected osteomyelitis with a severe soft tissue loss. (B) Immediate postoperative picture showing the insetting of the sural flap at the recipient area with minimal skin tension.
case_images: DFA-1-5544-g002.jpg
case_images: PMC3284307_01_DFA-1-5544-g002.jpg
case_images: F0002
case_images: The sural flap was then rotated to the defect area and was secured without any skin tension (Fig. 2).
case_images: Postoperative outcome at 4-month follow-up.
case_images: DFA-1-5544-g003.jpg
case_images: PMC3284307_01_DFA-1-5544-g003.jpg
case_images: F0003
case_images: The flap was completely healed and the patient was ambulatory with a custom molded shoe at 4 months postoperatively (Figs. 3 and 4).
case_images: Final postoperative outcome and range of motion of the ankle at 7-month follow-up.
case_images: DFA-1-5544-g004.jpg
case_images: PMC3284307_01_DFA-1-5544-g004.jpg
case_images: F0004
case_images: The flap was completely healed and the patient was ambulatory with a custom molded shoe at 4 months postoperatively (Figs. 3 and 4).