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Reulceration and Reoperation Incidence After Isolated Partial Fifth Ray Amputations: A Multicenter Study
Hayden L Hoffler1, Benjamin J Honeycutt1, Clark K Brackney1
1Resident, Podiatric Medicine and Surgery Residency Program, Department of Orthopaedic Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC.
Summary
Reulceration is common after fifth ray amputations, affecting 60.7% of patients. The location of the fifth ray amputation did not impact reulceration rates, suggesting it can be a viable salvage procedure.
Area of Science:
- Podiatric Surgery
- Orthopedic Surgery
- Amputation Surgery
Background:
- Reulceration is a frequent complication after fifth ray amputations.
- Partial fifth ray amputation is often used to manage infection and preserve ambulation.
Purpose of the Study:
- To determine the incidence of reulceration following partial fifth ray amputations.
- To investigate the association between the location of fifth ray amputation and reulceration development.
Main Methods:
- A multicenter review of 117 consecutive limbs undergoing partial fifth ray amputations.
- Procedures were performed at various levels of the fifth metatarsal.
- Postoperative ulceration was assessed on the ipsilateral foot.
Main Results:
- 60.7% of patients (71/117) experienced reulceration.
- No statistically significant difference in reulceration rates was found based on amputation location (p=0.166).
- Significant differences in follow-up time, reoperation rates, and reulceration rates were observed between study sites.
Conclusions:
- Partial fifth ray amputation can serve as an effective initial salvage procedure.
- The location of fifth ray amputation is not associated with the development of reulceration, transfer lesions, or more proximal amputations.
