Should this gout patient undergo surgery, or not? And if he does, then which type of surgery should be chosen?
The doctors in the department found themselves in quite a dilemma, for the gout had progressed so severely, such that they were devoid of any sound solutions for this patient.
The patient had visited numerous hospitals seeking treatment. Both his ankles were ruptured by massive tophi from the gout, releasing endless quantities of "chalk-like" substances. The wound was becoming increasingly larger and deeper, inhabited by various drug-resistant bacteria. It was persistent and did not show any signs of improvement. The terminations of both his tibia and fibula, talus, and heel bones were all exposed, with some parts necrotic, developing into chronic osteomyelitis.
A wound like this had virtually no chance of healing.