← Debridement and Drainage Clinical Cases

Diabetic Foot Multiple Plantar Sinus Tracts With Complete Bone Preservation

Clinical presentation, surgical treatment and documented healing.

01 / Problem: Clinical presentation
02 / Procedure: Surgical approach
03 / Outcome: Healing & follow-up

Clinical photographs below include wounds and surgical treatment.

01 / CLINICAL PRESENTATION

Problem

A 47-year-old woman with Type 2 Diabetes Mellitus and morbid obesity presented with diabetic foot complicated by multiple interconnected plantar sinus tracts caused by deep soft-tissue infection. Clinical and intraoperative assessment confirmed that no bone involvement was present, allowing complete soft-tissue treatment without skeletal resection.

Diabetic Foot Multiple Plantar Sinus Tracts With Complete Bone Preservation before image — Problem

02 / SURGICAL APPROACH

Procedure

All sinus tracts were fully laid open and converted into a single wound. Extensive debridement removed all infected and non-viable tissue until healthy, bleeding margins were achieved, while preserving every phalanx and metatarsal because no osseous infection was identified.

03 / HEALING & FOLLOW-UP

Outcome

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 even extensive plantar sinus tracts do not necessarily require bone resection; meticulous surgical exploration can preserve the entire skeletal architecture when bone viability is maintained.