PMC7187760_01
Pre-operative detection showed swelling and intermediate cuneiform displacement in the left foot. (A) Distinct swelling and 2 x 3-cm sized ulcer presented on the surface of left-foot dorsum; (B) X-ray detection revealed intermediate cuneiform fracture and displacement. The red arrows indicate the position of displaced intermediate cuneiform.
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F1
Apparent ischemic black margin and potential infection induced gangrene was observed (Figure 1A). X-ray detection revealed the hairline fracture and instep-orientated displacement of intermediate cuneiform (Figure 1B).
Post-operative detection showed successful debridement and ebonation. (A) Alleviated swelling presented on the surface of left-foot dorsum after debridement; (B) X-ray film view showed that the displaced intermediate cuneiform was removed. The red arrows indicate the position of removed intermediate cuneiform.
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F2
Clearing the obstruction by removing the displaced intermediate cuneiform (Figures 2A,B), ~50 ml yellow pus gushed from the wound.
Wound conditions at the (A) 7th, (B) 14th, (C) 24th, and (D) 40th day of posttherapy showed the gradual healing of ulceration and the timeline (E) of the treatment process from the day of operation (day 0) to the day of healing (day 40).
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F3
A week after surgery, pus was still overflowing from the ulcer wound (Figure 3A). Two weeks later, clear and fresh surface of ulcer presented while necrotic tissue also existed (Figure 3B). Twenty-four days after operation, the size of ulcer was distinctly shrunk and granulation tissue but not necrotic tissue was apparent on the surface (Figure 3C), thus the patient was discharged. Then, irrigation and dressing change were applied every 1-3 days until the ulcer healed entirely, ~40 days after operation (Figure 3D). To be clear, the timeline of entire treatment process was presented in Figure 3E.