Breaking the stalemate: a case of a laser-accelerated healing of a chronic tendon-exposed diabetic foot ulcer

Chronic diabetic foot ulcers remain a major clinical challenge, particularly when complicated by tendon exposure and failure to respond to standard care. We report a 47-year-old male with Type II diabetes mellitus with a history of smoking who developed a chronic ulcer of the fourth web space of the left foot. Following resolution of an initial soft tissue infection, the wound progressed to a non-healing ulcer with exposed but viable extensor digitorum longus tendon. Despite guideline-directed management, healing plateaued. Adjunctive Erbium:YAG laser therapy was introduced only after failure of prolonged standard conservative management as a secondary intervention, resulting in progressive wound contraction, tendon coverage, and complete epithelialization by 8 weeks. This case illustrates a stepwise approach to chronic diabetic foot ulcer management and the potential role of laser therapy after failure of standard care.