calacaneal osteomyelitis for management

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we are having a 50 year old male , chronic smoker has osteomyelitis of left calcaneum , with persitant discharging sinus over the heel region for 3 years duration.
sensation of the foot is normal. he was treated with ganslens procedure initially.

now patient is having persistent discharging sinus, pain on walking.

my questions are
can we proceed with removal of calcaneum,
if so how to reconstruct the heel region,
what about the weight bearing bone, inferior surface of talus ?
modified footwear following the procedure for offloading the heel..

suresh

 

Suresh,
Have you got an MR scan available to detect how far the osteomyelitis may be tracking? Or have you done any bone biopsies? The MR scan would also be useful in telling you how much of the rearfoot is viable bone. Have you got a good prosthetist? I think you'll need one if not.