Surgical Offloading after Revascularization for CLTI with Equinovarus Foot: A Case Report

Abstract

In the treatment of CLTI with foot deformity, there are many cases where ulcers recur due to poor compliance with the orthosis, even though the ulcers have been healed by revascularization. For foot deformities that are difficult to manage even with conservative offloading such as an orthosis, surgical offloading is recommended, which surgically corrects foot deformities and aims to distribute pressure. In this study, we performed surgical offloading (Achilles tendon lengthening and tibialis posterior tendon transfer) after revascularization for CLTI with equinovarus foot. Four years after surgery, the patient is able to walk barefoot and has no recurrence of ulceration. In cases of CLTI with foot deformity that is difficult to manage even with conservative offloading, surgical offloading should be considered in addition to revascularization.