Fig. 2

A 68-year-old man suffered from recalcitrant diabetic foot ulcer for 2 years. A Ischemic and necrotic toes and soft tissues at distal foot preoperatively. B Preoperative CTA image showed small vessels of the affected calf and foot were damaged. C, D The necrotic tissues were removed after debridement. E, F The triplanar osteotomy and external fixator sites were confirmed on radiographs postoperatively. G, H After medial distraction, the bone fragment is transported medially. I the image showed the affected foot during distraction. J The bone fragment was completely united 4 weeks after removal of the external fixator. K The ulcer was completely healed at 10 weeks postoperatively. L Postoperative CTA image showed more small vessels were present in the affected limb