A, Incision for removal of plantar bony prominence. B, Chronic plantar ulcer in neuropathic foot resistant to conservative treatment. C, Radiograph shows plantar bony prominence (arrow). D and E, Mass is exposed circumferentially. F, Wound is closed with large sutures in single layer, closing dead space. Percutaneous lengthening of Achilles tendon is frequently required. G, Twenty-one months after bony resection and use of protective insert and shoe.