The wound healed successfully following primary closure, with only minor superficial wound-healing issues that resolved during follow-up. The patient was subsequently fitted with a custom prosthetic filler and specialized therapeutic footwear, restoring a stable, plantigrade foot and enabling safe ambulation. This case demonstrates that, in selected patients with extensive metatarsal osteomyelitis, a Lisfranc amputation may provide superior long-term function compared with multiple isolated metatarsal resections.

The wound healed completely over approximately three months, without recurrent infection or the need for further proximal amputation.

This approach preserved a functional residual foot suitable for ambulation with customized therapeutic footwear, demonstrating that even advanced forefoot osteomyelitis can often be managed successfully with a well-planned limb-salvage strategy.

The wound healed successfully, and the patient regained independent ambulation using a customized therapeutic shoe.

This case demonstrates that even when osteomyelitis affects the last remaining ray after previous multiple ray amputations, limb preservation may still be achievable. Rather than progressing to a major amputation, careful surgical planning can eradicate infection while creating a stable, functional residual foot that allows continued walking and preserves the patient’s independence.

The wound healed uneventfully, allowing preservation of a functional foot and avoiding a major lower-limb amputation.

This case demonstrates that, when forefoot osteomyelitis is too extensive for isolated bone resections, a well-planned minor amputation such as a Lisfranc amputation can provide definitive infection control while maintaining limb function. Preserving a stable, weight-bearing residual foot offers substantially better rehabilitation potential than a major amputation and should be considered whenever oncologically—or in this case infectiously—safe margins can be achieved.

The wound healed completely in approximately 3 months.

This case illustrates that recurrent diabetic foot osteomyelitis after previous partial foot amputations does not necessarily mandate a more proximal amputation. Careful identification and complete removal of the newly infected bone, while preserving all uninvolved structures, can successfully eradicate infection, preserve the remaining foot, and maintain functional ambulation.

The wound healed completely by secondary intention within three months. Following healing, the patient was fitted with custom off-loading footwear to reduce plantar pressure and prevent recurrent ulceration. This case highlights the critical importance of long-term pressure off-loading after minor amputations, as inadequate footwear can lead to recurrent ulcers, osteomyelitis, and the need for further bone resection.

The wound healed completely in approximately 3.5 months, without the need for major amputation.

This case demonstrates that even calcaneal osteomyelitis—traditionally considered one of the most challenging diabetic foot infections—can often be successfully managed with aggressive bone-sparing surgery and preservation of the heel soft tissues. Careful eradication of infection, while maintaining the native weight-bearing heel pad, allowed limb salvage and preserved independent walking despite a previous recommendation for amputation.

Complete wound healing was achieved in approximately three months.

This case demonstrates that even a longstanding plantar ulcer of seven years can heal rapidly once the underlying osteomyelitis is surgically eradicated. Targeted bone resection eliminated the source of chronic infection, preserving a functional, weight-bearing foot while avoiding major amputation.

Complete wound healing was achieved in approximately four months. This case illustrates that residual osteomyelitis after incomplete bone resection does not necessarily mandate major amputation. Careful revision surgery combined with NPWT can successfully eradicate persistent infection while preserving a functional, weight-bearing foot.

Complete wound healing was achieved in approximately three months.

Despite developing a second episode of metatarsal osteomyelitis two years after the initial limb-sparing procedure, the patient again avoided major amputation. Sequential conservative bone resections successfully eradicated infection while preserving a functional, weight-bearing foot, demonstrating that recurrent diabetic foot osteomyelitis can often be managed with repeat limb-salvage surgery rather than more proximal amputation.