Reoperation and Reamputation Rates After Hallux Amputations versus Partial First-Ray Amputations

Foot infections are a common condition that foot and ankle providers treat. For patients who require an amputation, surgeons must decide what level of amputation to perform based on the extent of infection, soft-tissue viability, and the biomechanics of the foot. Although the literature has shown the high risk of repeated ulceration and amputation after a foot ulcer, there has been little published comparing partial first-ray amputation with hallux amputation.

The present study looked at reoperation and reamputation rates in 295 patients with either a partial first-ray amputation or a hallux amputation for treatment of infection.

Almost half of both groups required a reoperation: 41.1% and 42.9% in the hallux and partial first-ray amputation groups, respectively. There was a 31.9% distal amputation rate in the hallux amputation group and a 27.9% rate in the partial first-ray amputation group. There was found to be a 10.6% and 16.9% major amputation rate in the hallux amputation and partial first-ray amputation groups, respectively. We found no statistically significant differences between these two groups regarding reoperation rates and distal or major amputations.

Either procedure is appropriate for infections of the first ray, and the level of amputation should be determined based on the extent of the infection and soft-tissue coverage.