“Closing the Gap” in Rural Greece: Foot Ulcer Reconstruction in an Octogenerian. Case Presentation with Literature Review

Abstract

Foot ulcers of mixed aetiology are frequent in the elderly population. The majority of lower limb ulcerations are related to vascular disease. Diabetic foot ulcers constitute an outstanding paradigm of the coexistence of neurotrophic and vascular pathology. In this article, we present the case of an 89-year-old patient from a rural area of Greece. After total onychectomy for a subungual abscess of the hallux of the left lower limb, an ulcer developed on the tip of the hallux that prevented the nail from further growing. After surgical debridement of the ulcer, partial closure was achieved with a cutaneous advancement flap from the plantar surface of the distal phalanx. Strict adherence to simple but basic surgical principles is essential in dealing with minor surgical problems of daily practice in patients residing in rural areas of the country.