A 67-year-old woman with Type 2 Diabetes Mellitus presented with a diabetic foot plantar sinus tract associated with deep soft-tissue infection. Clinical and intraoperative assessment confirmed that the tract did not involve bone, allowing a limb-sparing procedure without osseous resection.

The entire sinus tract was surgically laid open, converting the tunnel into a single open wound, and all infected, non-viable soft tissue was meticulously excised until healthy, bleeding margins were achieved. The phalanges and metatarsals were completely preserved, as no bone involvement was identified.

The wound healed completely within 3.5 months, with complete resolution of infection. All bones were preserved, maintaining the foot’s anatomy and function while avoiding unnecessary bone resection.

This case demonstrates that plantar sinus tracts do not always require bone resection; when bone involvement is absent, meticulous surgical exploration and complete excision of the sinus tract can eradicate infection while preserving the entire osseous architecture of the foot.