Foot and Ankle Specialists of Tennessee

Today's case is a revision case where the patient had previously undergone a resection of a painful Haglund's deformity from the back of her left heel with detachment and reattachment of the left Achilles tendon. The patient had difficulty with healing her incision due to medical comorbidities and history of smoking.

When the patient presented to me for a second opinion, she was noted to have two draining sinuses with significant osteomyelitis involving her posterior calcaneus. Drainage was noted to have a blue/green hue, consistent with a chronic pseudomonal infection. Her previous surgeon had recommended a below knee amputation after reviewing her MRI results.

Our initial strategy was a two step approach with immediate initiation of 8 weeks of IV antiobiotics followed by definitive surgical intervention. Upon further review, the plan was for full removal of the previously used bone anchors, debridement of the devitalized calcaneal bone, and filling of the void with antibiotic impregnated bone cement. Ironically, several days prior to her planned surgical revision, one of the anchors was noted to be protruding from the sinus and was actually explanted and removed in office, as pictured.

Included are the preoperative photos of the case and the intraoperative photos with x-rays showing the large bone void and cement spacer used to fill the void.

The patient is now approximately 1.5 years status post and doing very well at this time with full resolution of her infection and significant improvement of pain.

Hardware failures can happen to the best of us. This particular plate was used for a severe hallux valgus deformity (bunion) with deterioration of the joint. A previous bunionectomy surgery had been attempted, but the deformity recurred. After careful consideration, a fusion of the great toe joint was performed. After cyclic loading of the joint, the plate subsequently broke, requiring revision. Pictured is the plate after removal, a little worse for wear.

My ankle had been damaged with multiple injuries throughout my life and had basically given out on me completely. My previous podiatrist said it would be a complicated surgery and sent me to Dr. Roland because he trusted that he could handle it. And he was right! Extensive surgery, months of healing and physical therapy but my ankle has never felt more secure and stable in my life. I am eternally grateful to Dr. Roland for taking such good care of me throughout the entire process. He is a confident and incredibly skilled surgeon who listens and honestly cares for his patients. Thank you so much!
- Kellye

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We are very excited and proud to share our new Cedar Bluff office location. Come visit Dr. Derrick Roland at our new location and see the difference for yourself. Our dedicated team of specialists are here for you. We feature a spacious lobby, comfortable and open waiting area, and large exam rooms with easily accessible chairs. We are fully handicap accessible. We specialize in all foot, ankle, and leg related issues including pain, sprains, injuries, fractures, wounds, and more.

We look forward to caring for you and your loved ones.
Let us help, call 865-686-8486.

Dr. Derrick Roland is a board qualified, fellowship-trained podiatric surgeon with specialty in modern surgical techniques, including all aspects of elective, trauma, reconstructive, limb salvage, and minimally invasive. Dr. Roland is a devoted patient advocate, whose approaches center around both patient education and the latest evidence-based research. It is important to Dr. Roland that his patients understand their health and select the individualized treatment option that best fits their unique needs and lifestyles. Dr. Roland prides himself on his ability to discuss complex foot and ankle problems with patients in a concise and easy to understand way.