Three years progress chronic limb-threatening ischemia case with simultaneous surgery

Chronic limb-threatening ischemia (CLTI) is a severe limb problem. The causes of foot ulcer are influenced by several factors, which lead to ischemia and foot deformity causing recurrence after wound healing. This report focuses on the long-term course. An 80-year-old male with CLTI was treated. The patient had an ulcer in the second toe of his left foot and stenosis of above the knee vessels. He performed his daily activities independently and his left foot was hallux valgus. After improving blood flow, foot deformity was corrected with ulcer treatment. The patient's second toe was amputated after the endovascular treatment. Finally, the toe was closed and hallux abductive valgus was corrected at the same time. After three years, he had no recurrence of foot ulcer. The patient uses a foot orthosis and his life is independent with no recurrence. Surgical offloading is an effective method to prevent recurrence. Surgical offloading is sometimes performed in patients with CLTI, but there is few occasion to undergo. This is because, there are problems of re-ischemia and an advanced age. Therefore, simultaneous surgery, as in this case, could be useful and help reduce the ulcer recurrence rate. Simultaneous surgery for CLTI was useful in leading to a reduction in recurrence rate. •Simultaneous surgery (surgical offloading and ulcer closed operation) could be useful and help reduce the ulcer recurrence rate, because chronic limb-threatening ischemia has a problem of recurrence.•After improvement of blood flow, chronic limb-threatening ischemia patient can be underwent surgical offloading.•Patients who have undergone simultaneous surgery can maintain a long-term quality of life.•Simultaneous surgery is relatively easy and saves surgeons time and effort to perfume surgical offloading another time.