A 65-year-old man with diabetes presented with plantar hallux osteomyelitis and a deep plantar ulcer involving the phalanges of the great toe. The location of the ulcer on the weight-bearing surface made durable wound closure particularly challenging.

Radical surgical debridement and resection of the infected phalanges were performed while preserving the soft-tissue envelope of the hallux. The wound was managed by secondary intention until complete granulation and epithelialization were achieved.

The wound healed completely by secondary intention within approximately 3 months, without hallux amputation.

Despite the challenging plantar location, complete eradication of osteomyelitis was achieved while preserving the great toe, maintaining its weight-bearing function and contribution to normal gait.