An 82-year-old woman presented with an infected diabetic toe ulcer with exposure of the extensor tendon. Tendon exposure represents a particularly challenging wound because of its poor vascularity and the high risk of persistent infection, delayed healing, and toe loss.

Serial surgical debridements were performed, removing all infected and non-viable tissue until healthy, bleeding margins were achieved. The exposed tendon was carefully preserved while meticulous wound bed preparation promoted progressive granulation tissue formation and secondary healing.

The wound healed completely with full coverage of the previously exposed tendon, avoiding amputation and preserving the toe’s anatomy and function.

This case demonstrates that exposed tendons are not synonymous with amputation; with meticulous surgical debridement and specialized wound management, durable healing and complete toe preservation are achievable.