Over the inner aspect of the heel there is a large ulcer with sharply defined fibrotic margins. The
base of the ulcer in its lower portion is formed by granulation tissue in which there is some
haemorrhage; in the upper portion of the ulcer the floor communicates with a fracture in the os
This woman presented at the age of 48 with a one year history of an ulcer which would
not heal. She had a long history of poorly controlled diabetes and she had had episodes of
thrombophlebitis in that leg. The ulceration is assumed due to a combination of venous stasis and
diabetic arteriopathy. The presence of a fracture was not accounted for in the history. The patient
was grossly obese and had osteoarthritic changes in her hips and knees.