Related Experiment Video
Updated: Jul 19, 2026
09:01
Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
Published on: January 24, 2018
Transmetatarsal amputation: predictors of healing
Tien H Nguyen1, Ian L Gordon, Delores Whalen
1Surgical Service, Long Beach Veterans Administration Medical Center, California, USA.
The American Surgeon
|October 25, 2006
Summary
Further debridement after transmetatarsal amputation (TMA) predicts failure, potentially leading to higher amputations. Smoking and infrapopliteal occlusion are also risk factors for nonhealing.
Area of Science:
- Vascular Surgery
- Podiatric Surgery
- Amputation Outcomes
Background:
- Transmetatarsal amputation (TMA) is a limb-sparing procedure for severe foot pathology.
- Predicting TMA healing and identifying factors for higher amputation levels is crucial for patient outcomes.
Purpose of the Study:
- To identify predictors of healing after transmetatarsal amputations (TMA).
- To determine factors associated with requiring a higher level of amputation following TMA.
Main Methods:
- Retrospective review of 33 TMAs in 31 male patients (2000-2005).
- Analysis of risk factors including infrapopliteal arterial occlusion, smoking history, and repeat debridement.
- Univariate and multivariate analyses to assess predictors of TMA failure.
Main Results:
- 57% of TMAs were successful; 40% required higher amputation.
- Multivariate analysis identified further TMA debridement as a significant risk factor for TMA failure (P=0.01).
- Univariate analysis showed infrapopliteal occlusion and long-term smoking (>20 years) were also risk factors.
Conclusions:
- Further debridement is a key predictor of transmetatarsal amputation failure.
- Aggressive TMA may be warranted for ambulatory patients, but risks like smoking and arterial disease must be considered.
- Identifying high-risk patients can guide surgical decisions and improve limb salvage rates.
Related Concept Videos
01:31Diabetic Foot Ulcer
Definition A diabetic foot ulcer (DFU) is a chronic, non-healing wound that develops in individuals with diabetes. It typically occurs on pressure-bearing areas such as the heel, metatarsal heads, or hallux, and carries a high risk of infection and amputation.Pathophysiology • The development of DFUs can be explained by four interconnected mechanisms: neuropathy, ischemia, infection, and impaired wound healing. • Neuropathy is the most common factor. Sensory neuropathy reduces pain perception,...
01:23Peripheral Artery Disease V: Postoperative Nursing Management
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...