The heel forms the back arm of the internal and external longitudinal arch of the foot, and bears 50% of the gravity of the whole body when standing, which is an important functional organ for people walking with weight. The heel bone is the largest tarsal bone, mainly composed of cancellous bone, connected to the dice bone, navicular bone and talus bone through the articular surface and ligaments, and surrounded by few soft tissues, often combined with soft tissue damage when fractured, pathogenic bacteria can easily break through the defense barrier and directly attack the cancellous bone, resulting in refractory heel osteomyelitis.
Achilles osteomyelitis: the inflammatory reaction process of microbial infection of the heel bone due to trauma and other reasons, followed by bone destruction. Zhou Zhenyu, Department of Bone Trauma Surgery, Jinan Military General Hospital
With the advancement and application of antibiotics, the prognosis of osteomyelitis has greatly improved, but it is still one of the most challenging challenges faced by orthopedic surgeons.
Difficulties in the treatment of heel osteomyelitis.
1, antibiotics and inflammatory cells, blood nutrients can not reach the ischemic area, systemic antibacterial and other therapeutic values are limited.
2, the surrounding soft tissue is small, and the cavity is difficult to fill after lesion removal, while the lesion soft tissue wraps the dead bone, if not removed, the bone isolation cannot be broken, and the bacterial habitat cannot be dissected.
3, lesion removal does not improve blood circulation.
4, the heel is a functional unit, the removal of local tissue is bound to cause the loss of foot function.
The key to the treatment of heel osteomyelitis.
1, thorough removal of degenerative soft tissue and dead bone, open bone isolation, and retain viable bone tissue scaffold.
2.Improve the blood circulation of the local tissues of the heel through the bypass by transplantation of healthy tissues with good blood circulation.
3.Through the principle of what is lacking and what is being patched, a phase of repair, reconstruction of heel bone and soft tissue defects, bone and soft tissue together.
4.Restore the structural integrity of the foot according to the functional requirements of each heel department; implement functional reconstruction simultaneously while curing heel osteomyelitis.
Typical case one
Typical case two
Typical case three
Typical Case 4
Typical Case 5