Ray resection in the dysvascular foot. A retrospective review

Twenty-nine ray resection amputations of the lower extremity were performed in 25 dysvascular patients during a four-year period. The indications for amputation were localized gangrene, resistant localized osteomyelitis of a metatarsal, or both. Specific criteria included: (1) foot Doppler pressure of 70 mm Hg, (2) ankle-arm Doppler arterial pressure ratio of at least 0.5, (3) lateral ray resection only when healthy tissue margins could easily be produced, and (4) central ray resection only for persistent deep infection resistant to local treatment. Only 31% healed without further amputation or ulceration. Analyzed retrospectively, the results demonstrate that ray resection has a poor potential for success in the presence of "localized" gangrene and is only moderately successful in the treatment of chronic resistant localized infection.