Jacobs (1) reported use of the Clayton modification of the Hoffman procedure on 12 patients as the procedure of choice in select diabetics with abscess and ulceration. He described a dorsal transverse incision, amputation of all metatarsal heads, through-and-through drainage from a dorsal to plantar direction at the site of abscess formation, and use of a Jackson-Pratt drain dorso-laterally. The authors describe a modification of this procedure that has been performed for 6 years.