12/05/2015    Don Peacock, DPM

A Complication That Saved a Life

Dr. Bregman I have a similar story that I believe
resulted in limb salvage for one of my patients.
I was referred an uncontrolled diabetic patient
with a 6 month limb threatening sub-3rd
metatarsal ulceration. Her circulation was also
affected by her diabetes and she had been on
Levaquin for 1 month.

For these ulcers I have employed gastrocnemius
recession with the usual good results that most
of us get with this soft tissue rebalancing. I
was reluctant to perform the surgical
intervention because of her poor health status.

My first step was to culture her wound which
resulted in taking her off the Levaquin and
ordering outpatient IV antibiotics for six weeks.
One morning while going to her a.m. dose her
husband was helping her into the outpatient IV
clinic and he tripped on a curb resulting in a
hip fracture. While she was getting her dose of
antibiotic her husband underwent emergency hip
surgery.

He was also in poor health and required admission
into the hospital. Afterwards she went to
recovery to visit her husband and retrieved the
car keys from him. On the way to her car she
tripped on the same curb and heard a loud popping
in the back of her heel. She was able to make it
home and visited our office the next day. She
had ruptured her Achilles/Gastroc tendon near the
perfect point of placing a distal gastrocnemius
recession.

As a result of her injury the ulcer completely
healed and she remained ulcer free following the
injury. Her husband also had other serious
underlying medical issues that he had been
neglecting. As a result of his injury he was
treated for these medical conditions as well.
Both my patient and her husband became healthier
after their accidents. These events saved her
limb and possibly his life.

Don Peacock, DPM, Whiteville, NC

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