A 74-year-old man with type 2 diabetes was referred from another hospital after previous amputation of the first and second rays for diabetic foot osteomyelitis. Despite the earlier surgery, he developed recurrent osteomyelitis involving a tarsal bone, with persistent infection threatening further loss of the foot.

Limb-sparing surgery was performed with meticulous excision of the infected tarsal bone until healthy, bleeding bone margins were obtained. Every effort was made to preserve the remaining viable foot architecture and surrounding soft tissues, allowing eradication of the infection while maintaining the maximum possible structural stability and function.

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.