Clinical Outcomes of Ostectomy Vs. Conventional Management for Non-Healing Pressure Ulcers of the Great Toe

Open Access

Abstract

Introduction: Non-healing pressure ulcers of the great toe are a challenging clinical problem, often associated with prolonged pressure, neuropathy, infection, and underlying comorbidities such as diabetes or peripheral vascular disease. This study aimed to compare the clinical outcomes of ostectomy versus conventional management in patients with non-healing great-toe pressure ulcers. Methods & Materials: This was a prospective comparative study conducted at a tertiary care hospital in Dhaka, from January 2024 to July 2025, involving 100 patients with non-healing pressure ulcers of the great toe who were allocated into two groups of 50 each. Data were analyzed using SPSS version 26.0. Results: Group A showed significantly better healing outcomes, with higher complete healing at 12 weeks (84% vs 48%) and shorter healing time (10.4 vs 11.2 weeks). Recurrence was lower in Group A (12% vs 28%), and fewer required additional surgery (8% vs 24%). Minor complications were comparable, and no major complications occurred. Functional outcomes favored Group A, with more patients returning to normal footwear (76% vs 48%) and improved gait stability (80% vs 52%). Conclusion: In this study, ostectomy demonstrated significantly higher healing rates and shorter mean time to healing compared with conventional management. Specifically, 80% of patients in the ostectomy group achieved complete ulcer closure within almost 10 weeks, compared with 52% in the conventional care group. Infection resolution and reduction in ulcer recurrence were also more favorable with ostectomy.