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Related Experiment Videos

Transmetatarsal amputation: an 8-year experience.

S R Thomas1, J M Perkins, T R Magee

  • 1Department of Surgery, Royal Berkshire Hospital, London Road, Reading RG1 5AN, UK.

Annals of the Royal College of Surgeons of England
|July 4, 2001
PubMed
Summary
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Transmetatarsal amputation (TMA) for forefoot ischemia offers mobility but healing is unreliable, especially in diabetic patients. Failed healing often necessitates higher-level amputations, requiring thorough patient discussion.

Area of Science:

  • Vascular Surgery
  • Diabetic Foot Complications
  • Limb Salvage Surgery

Background:

  • Forefoot ischemia is a common complication in diabetic patients.
  • Transmetatarsal amputation (TMA) is a surgical option for severe forefoot ischemia.
  • Outcomes of TMA, particularly in diabetic versus non-diabetic populations, require further investigation.

Purpose of the Study:

  • To retrospectively evaluate the outcomes of transmetatarsal amputation (TMA) for forefoot ischemia.
  • To compare healing rates and functional mobility between diabetic and non-diabetic patients undergoing TMA.
  • To identify factors influencing TMA success and the implications of failed healing.

Main Methods:

  • Retrospective review of 41 consecutive transmetatarsal amputations (TMA) over an 8-year period.

Related Experiment Videos

  • Analysis of peri-operative mortality, stump healing rates, and functional mobility.
  • Comparison of outcomes between diabetic and non-diabetic patient groups.

    • Main Results:

    • Peri-operative mortality was 17% (7/41).
    • Stump healing was achieved in 46% (19/41) of patients, with 18 achieving independent mobility.
    • Non-diabetic patients (8/12) had significantly better healing rates than diabetic patients (11/29).
    • Median healing time was 7 months; failed healing led to higher amputations in survivors.

    Conclusions:

    • A healed transmetatarsal amputation (TMA) can provide good functional mobility.
    • Predicting TMA healing is unreliable, with diabetic patients experiencing poorer outcomes.
    • Failed TMA healing often requires higher-level amputations, underscoring the need for comprehensive patient counseling.