Partial foot amputation in patients with diabetic foot ulcers

Area of Science:

• Podiatric surgery
• Diabetic foot complications
• Amputation outcomes

Background:

• Transtibial amputations (TTA) are common for severe foot ulcers but lead to reduced mobility.
• Partial foot amputations offer a theoretical advantage of an end-bearing limb and improved function.
• Investigating partial foot amputations as an alternative to TTA is crucial for optimizing patient outcomes.

Purpose of the Study:

• To compare the longevity, functional outcomes, and mortality rates of various partial foot amputations against transtibial amputations.
• To determine if partial foot amputations offer a superior alternative to TTA in diabetic patients.

Main Methods:

• Retrospective chart review of diabetic patients undergoing transmetatarsal, Chopart's, calcanectomy, or transtibial amputations.
• Comparison of 5-year mortality, reamputation rates, and validated ambulatory functional outcome scores between amputation types.

Main Results:

• Transmetatarsal amputations showed lower 5-year mortality than TTA (0.30 vs. 0.45) with good ambulatory scores (4.3).
• Chopart's amputations also demonstrated favorable ambulatory scores (4.3) and comparable mortality to TTA.
• Calcanectomy procedures exhibited higher mortality rates and lower ambulatory scores compared to TTA and other partial foot amputations.

Conclusions:

• Transtibial amputation is linked to significant morbidity and mortality.
• Transmetatarsal and Chopart's amputations demonstrate potential for improved survivorship and ambulatory function compared to TTA.
• Further investigation into partial foot amputations is warranted to optimize limb salvage and functional recovery in diabetic patients.