Rearfoot Realignment as a Prophylactic Strategy for Recurrent Lateral Column Ulcers in Diabetic Foot: A Case-Based Hypothesis

Lateral column ulcerations remain a persistent and complex challenge in diabetic foot management. Although procedures such as tailor’s bunionectomy may provide localized pressure relief, they often fail to address the underlying biomechanical contributors, most notably rearfoot deformities such as calcaneal varus or pes cavovarus frequently observed in diabetic patients. These structural abnormalities shift the weight‑bearing axis laterally, increasing ground reaction forces along the fifth metatarsal and predisposing individuals with diabetic peripheral neuropathy and impaired proprioception to recurrent ulceration. This case explores the hypothesis that prophylactic rearfoot realignment may offer superior long‑term outcomes by correcting the mechanical etiology of lateral column overload.