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Published on: May 2, 2012
Reoperation, reamputation, and new ulceration following complete or partial toe amputation among diabetic and
Carl G Speer1, Nicole K Rendos2, Calvin E Davis3
1Emerald Coast Foot and Ankle Center, 8333 N Davis Highway, Suite 6E, Pensacola, FL, 32514, United States; Podiatric Medicine and Surgery Residency Program, University of Pittsburgh Medical Center, 1400 Locust Street, Pittsburgh, PA 15219, United States.
Aims:
To compare the number of reoperations, reamputations, and new ulcers following toe amputation in diabetic and non-diabetic patients with sub-group analysis on index amputation level.
Methods:
One-hundred sixteen patients with a complete (CTA) or partial (PTA) toe amputation and minimum of 12-month (12 M) follow-up were identified in electronic medical records. The number of reoperations and reamputations, number and location of new ulcers, and final amputation level of the ipsilateral extremity were compared between diabetic and non-diabetic patients and between those with CTA and PTA at 12 M and final follow-up (FFU).
Results:
Diabetic patients had significantly more reoperations, reamputations, and new ulcers than non-diabetic patients at 12 M and FFU. There were no differences in reoperations, reamputations, or new ulcer location between CTA and PTA; however, patients with PTA developed more new ulcers at 12 M and FFU and were more likely to have a distal final amputation level compared to those with CTA.
Conclusions:
Diabetic patients required significantly more reoperations and reamputations following a toe amputation and developed more new ulcers than non-diabetic patients regardless of index amputation level. These high rates among diabetic patients highlight the complications encountered following toe amputation and emphasize the need for close, multi-disciplinary care.
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