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Are Transmetatarsal Amputations a Durable Limb Salvage Option? A Single-Institution Descriptive Analysis
Alexander R Tokarski1, Ellen C Barton1, Jacob T Wagner1
1Podiatric Medicine and Surgery Resident, Gundersen Health Systems, La Crosse, WI.
Summary
Transmetatarsal amputations can be durable limb salvage for diabetic foot infections. However, 44% of patients experienced re-ulceration, necessitating lifelong monitoring for diabetic foot care.
Area of Science:
- Podiatric surgery
- Diabetic complications
- Limb salvage procedures
Background:
- Diabetic foot infections often necessitate transmetatarsal amputations for limb salvage.
- Assessing the long-term durability of these procedures is crucial for patient outcomes.
Purpose of the Study:
- To analyze the long-term durability of transmetatarsal amputations in diabetic patients.
- To identify factors associated with re-ulceration and the need for further surgical intervention.
Main Methods:
- Retrospective review of 83 transmetatarsal amputations over 11 years.
- Definition of successful amputation as clinical healing at 1 year post-surgery.
- Analysis of long-term outcomes including re-ulceration and additional procedures.
Main Results:
- Mean follow-up was 4 years; mean healing time was 109.8 days.
- 44% of successful amputations experienced re-ulceration at a mean of 15 months.
- Younger patients and those with higher pre-procedure hemoglobin A1c were more prone to re-ulceration.
Conclusions:
- Transmetatarsal amputations are viable limb-preserving surgeries for diabetic foot infections.
- Lifelong monitoring is essential due to the significant risk of re-ulceration and potential need for more proximal amputations.
