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Related Experiment Video

Updated: Jun 2, 2026

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
09:01

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach

Published on: January 24, 2018

A modified transmetatarsal amputation.

Hiroto Terashi1, Ikuro Kitano, Yoriko Tsuji

  • 1Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. terashi@med.kobe-u.ac.jp

The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons
|May 17, 2011
PubMed
Summary

A modified transmetatarsal amputation preserves foot structures, improving outcomes for diabetic foot patients. This technique shows promise in reducing complications and maintaining mobility after forefoot gangrene surgery.

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Area of Science:

  • Podiatric Surgery
  • Diabetic Foot Management
  • Vascular Surgery

Background:

  • The incidence of diabetic foot complications, including the need for amputation, is rising globally.
  • Transmetatarsal amputation is a common procedure for diabetic foot, but improvements in surgical technique are needed.
  • Peripheral arterial disease often complicates diabetic foot cases, increasing amputation failure rates.

Purpose of the Study:

  • To introduce and evaluate a modified transmetatarsal amputation technique.
  • To preserve soft tissue structures and the longitudinal arch for improved foot function.
  • To reduce complications and enhance outcomes in patients with diabetic foot and/or peripheral arterial disease.

Main Methods:

  • A novel transmetatarsal amputation procedure was developed, focusing on preserving intermetatarsal soft tissue.

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Last Updated: Jun 2, 2026

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach
09:01

Treatment of Ankle Osteoarthritis with Total Ankle Replacement Through a Lateral Transfibular Approach

Published on: January 24, 2018

  • The preserved soft tissue, including vasculature and periosteum, was applied to distal bone stumps.
  • The modified technique was applied to a cohort of 11 patients with diabetes mellitus and/or peripheral arterial disease.

    • Main Results:

    • All surgical wounds in the 11 patients achieved successful primary closure.
    • Eight patients (73%) survived without complications; 6 could ambulate with custom footwear.
    • Three patients died; causes included sepsis and cerebral infarction, with one death from natural causes.

    Conclusions:

    • The modified transmetatarsal amputation technique demonstrates potential as a breakthrough in treating forefoot gangrene.
    • Preserving soft tissue and the longitudinal arch may lead to better functional outcomes.
    • This innovative approach warrants further investigation and may gain clinical acceptance.