Transmetatarsal and midfoot amputations

The objective of lower extremity amputation surgery is to create a viable, functional residual limb to maximize patient mobility and independence. When part or all of the forefoot is lost to trauma, infection or gangrene, and the hindfoot is viable, every attempt should be made to preserve as much foot function as possible. The use of the transmetatarsal level is common. In the past, amputations through the Lisfranc and Chopart's joint lines involved significant complication rates. With improvements in patient selection and surgical technique, these two amputation levels are viable options to consider when attempting salvage of the hindfoot structures.