An 80-year-old patient with type 2 diabetes presented with a severe ischemic heel ulcer caused by diabetic peripheral arterial disease. Before referral for surgical treatment, the patient underwent endovascular revascularization (angioplasty) to restore blood flow and improve the potential for limb salvage.

After successful revascularization, a heel-sparing partial calcanectomy was performed, removing the infected and non-viable portion of the calcaneus together with all necrotic soft tissue while preserving the remaining heel. The wound was intentionally left open and managed by secondary intention healing, combined with meticulous wound care and strict pressure off-loading.

Complete healing was achieved by secondary intention within 8 months, resulting in a durable, weight-bearing heel and preservation of independent ambulation. This case demonstrates that even large ischemic heel defects can heal successfully without major amputation when blood flow is restored and only the non-viable calcaneal bone is removed. Preserving the heel preserves the patient’s ability to stand, walk, and maintain functional independence.