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Transmetatarsal amputation

D J Effeney, R C Lim, W P Schecter

    Archives of Surgery (Chicago, Ill. : 1960)
    |November 1, 1977
    PubMed
    Summary
    This summary is machine-generated.

    Transmetatarsal amputation is a viable option for select patients with distal foot gangrene. Success rates are favorable, but younger patients with diabetes face higher risks of complications and re-amputation.

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    Area of Science:

    • Podiatric Surgery
    • Vascular Surgery
    • Orthopedic Surgery

    Background:

    • Transmetatarsal amputation (TMA) is a surgical procedure to remove the forefoot.
    • Indications for TMA include peripheral artery disease, diabetes, trauma, and nonhealing ulcers.
    • Patient selection is crucial for successful TMA outcomes.

    Purpose of the Study:

    • To evaluate the outcomes of transmetatarsal amputations.
    • To identify factors associated with successful healing and ambulation.
    • To determine predictors of failure and need for higher amputation.

    Main Methods:

    • Retrospective review of 25 patients undergoing TMA at San Francisco General Hospital.
    • Analysis of patient demographics, comorbidities, surgical indications, and outcomes.

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  • Comparison of characteristics between patients who healed and those who required higher amputation.

    • Main Results:

    • Thirteen of 25 patients (52%) healed their TMA and became ambulatory.
    • Eleven patients (44%) required a higher amputation due to infection (7) or ischemia (4).
    • The failure group was younger, had a higher incidence of diabetes, and more infections.

    Conclusions:

    • Transmetatarsal amputation can be successful in patients with distal gangrene and no spreading infection.
    • Below-knee amputation should be reserved for cases with more extensive foot involvement.
    • Careful patient selection, particularly regarding diabetes and infection, is vital for optimizing TMA outcomes.