Diabetic foot osteomyelitis is a severe diabetes complication that increases the risk of limb loss and death. This study assessed a one-stage surgical approach with primary wound closure and local antibiotics, showing favourable results. Among 97 patients, 13 needed further treatment, but only 4 required major amputation. Poor circulation was the main factor in failure. These findings challenge traditional methods and may improve quality of life, although further high-quality trials are needed.