Transmetatarsal and midfoot amputations

This article discusses transmetatarsal and midfoot amputations, selection of level, criteria for wound healing, surgical techniques, and functional considerations. Amputations through the middle of the foot include the Lisfranc amputation at the tarsometatarsal joints and the Chopart amputation at the midtarsal joints. Both of these procedures result in the development of equinovarus deformity, and require lengthening of the Achilles tendon. Transmetatarsal amputation preserves foot function, is cosmetically acceptable and does not require a prosthesis. Satisfactory limb salvage can be achieved by the motivated patient and knowledgeable surgeon when these procedures are employed.