An 83-year-old woman presented with an infected diabetic foot ulcer over the first metatarsal head (hallux valgus deformity). This is a particularly challenging location because it is subjected to constant pressure during walking, making durable wound healing difficult and increasing the risk of recurrent ulceration.

Radical surgical debridement was performed, removing all infected and non-viable tissue until healthy, bleeding margins were achieved. Careful wound bed preparation and pressure off-loading promoted progressive granulation tissue formation and healing by secondary intention.

The wound healed completely within approximately 3 months, with preservation of the foot and restoration of durable soft-tissue coverage. This case demonstrates that even ulcers located over high-pressure weight-bearing areas can heal successfully when meticulous surgical debridement is combined with effective pressure off-loading and specialized wound care.