A 45-year-old man with type 2 diabetes presented with a plantar diabetic foot ulcer complicated by extensive osteomyelitis of the second ray, involving both the second metatarsal and the phalanges of the second toe.

Radical debridement with complete resection of the infected second metatarsal and second toe phalanges was performed until healthy, infection-free bone margins were achieved. The wound was managed with negative pressure wound therapy (NPWT) followed by secondary intention healing.

The wound healed completely within 50 days.

Despite complete resection of the infected second ray, the remaining forefoot was preserved, achieving infection eradication while maintaining a functional, weight-bearing foot.