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Transmetatarsal amputation for advanced forefoot tissue loss in elderly patients
F G Quigley1, I B Faris, H Xiouruppa
1University Department of Surgery, Royal Adelaide Hospital, North Terrace, South Australia.
Summary
Transmetatarsal amputation can preserve mobility, but has a high revision rate. Preserving the heel significantly improves the chance of maintaining independent mobility after this forefoot amputation procedure.
Area of Science:
- Podiatric surgery
- Orthopedic surgery
Background:
- Transmetatarsal amputation is a surgical procedure for advanced forefoot tissue loss.
- It aims to preserve mobility compared to major amputation.
Purpose of the Study:
- To evaluate the outcomes of transmetatarsal amputations.
- To identify factors influencing healing and mobility preservation.
Main Methods:
- Retrospective review of 33 consecutive transmetatarsal amputations.
- Analysis of revision rates and mobility outcomes.
- Comparison of patient factors (heel preservation, non-invasive tests, smoking, diabetes, age).
Main Results:
- A high revision rate to major amputation was observed (18/33).
- Preserving the heel significantly increased the likelihood of maintaining independent mobility (P = 0.01).
- No significant differences were found in healing based on non-invasive test results, smoking, diabetes, or age.
Conclusions:
- Transmetatarsal amputation offers a chance for mobility preservation despite a high revision rate.
- Heel preservation is a critical factor for successful independent mobility post-procedure.
- Future improvements may involve enhanced non-invasive testing, wound care, and revascularization techniques.