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Risk Factors for Lower Extremity Minor Amputation Conversion to Major Amputation.

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Minor lower extremity amputations (LEAs) vary in outcomes. Midfoot amputations have higher major amputation conversion rates, while toe/ray amputations see more repeat minor procedures, impacting wound healing and future limb salvage success.

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Area of Science:

  • Vascular Surgery
  • Orthopedic Surgery
  • Podiatric Surgery

Background:

  • Minor lower extremity amputations (LEAs) are crucial for limb salvage but carry risks.
  • Outcomes and conversion to major amputation differ between toe/ray and midfoot amputations.

Purpose of the Study:

  • To compare outcomes of toe/ray versus midfoot amputations.
  • To identify risk factors for major amputation conversion after minor LEAs.

Main Methods:

  • Retrospective chart review of 375 foot amputation patients.
  • Comparison of toe/ray vs. midfoot amputation groups.
  • Analysis of conversion to major amputation, wound healing, and mortality rates.

Main Results:

  • Toe/ray amputations had more repeat minor amputations (34.7%) and better 90-day wound healing.
  • Midfoot amputations showed a higher conversion to major LEA (20.8%) within 1 year.
  • Overall 1-year mortality was 6.17% with no significant difference between groups.

Conclusions:

  • While overall mortality is similar, risk factors for major amputation conversion differ between minor LEA types.
  • Findings aid surgeons in selecting appropriate amputation levels.
  • Informed patient understanding of healing and repeat amputation risks is enhanced.