Objectives: The best treatment for displaced, intra-articular fractures of the calcaneus remains controversial and it is generally agreed, that there is no single method that is suitable for all patients. Case presentation: Here we report a rare case of bilateral calcaneal osteomyelitis with fistula formation following open reduction and plate fixation via an extensile lateral approach that could be salvaged with an interdisciplinary approach including orthopedic and plastic surgeons. We are not aware of a similar case in the literature. Abductor digit minimi flaps is a well-established procedure in plastic and reconstructive surgery with a minimal functional defect and morbidity at the donor site. This treatment protocol resulted in minimal donor-site morbidity and good bone remodeling in the further course. We believe that it may be of use for complicated courses even with limited resources. Conclusions: Abductor digit minimi flaps is a well-established procedure in plastic and reconstructive surgery with a minimal functional defect and morbidity at the donor site.