While transmetatarsal amputations can be a viable remedy for diabetic foot ulcers and other diabetic foot complications, there are variable. This paper provides an overview of the transmetatarsal amputation (TMA) as a limb salvage procedure and is written with the perspective and. Transmetatarsal Amputation. Pre-Op Plan: Patient positioning: Left hip towel bump to roll the patient slightly and keep the left leg from externally rotating.


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No demographic or perioperative variables significantly predicted healing. Mean survival was Significant predictors of mortality were dialysis-dependent renal transmetatarsal amputation odds ratio, 4.

Transmetatarsal amputation healing, however, significantly predicts subsequent ambulatory transmetatarsal amputation and should be pursued in patients with good rehabilitation potential.

For many patients with multiple toe or distal foot gangrene, a transmetatarsal amputation TMA is the last hope for partial foot salvage.

Predictors of Healing and Functional Outcome Following Transmetatarsal Amputations

Preservation of a sensate heal is desirable for maintaining ambulatory function. However, wound healing of TMA is frequently a major challenge.

Nonhealing of TMA inevitably leads to multiple operations and hospitalizations, ultimately resulting in a more proximal, frequently transtibial, amputation.

Although transtibial amputations heal more reliably than TMAs, patients are often resistant to this procedure, and subsequent ambulation with a prosthesis is often more difficult than transmetatarsal amputation on the native heal and forefoot.

Given the difficulty in healing of TMA, however, it would be desirable to predict transmetatarsal amputation patients are less likely to heal and to possibly avoid the prolonged periods of medical care in these patients.

Transmetatarsal Partial Foot Amputation

Typically, the judgment of an experienced physician is one of the best indicators of subsequent healing. Other adjunctive measures, such as ankle brachial indices, toe pressures, 8 laser Doppler skin perfusion pressures, 9 angiography, 3 and Doppler assessment of foot vasculature, 10 are occasionally used to assist in transmetatarsal amputation decision.

Transmetatarsal amputation our practice, we have used a variety of tests to help determine optimal amputation levels, most recently, skin perfusion pressures.

Here, we review our experience with TMA healing and examine factors that might help predict amputation healing. Consecutive patients transmetatarsal amputation a history of TMA were included, regardless of outcome.

  • Transmetatarsal Amputation | JAMA Surgery | JAMA Network
  • Trans-metatarsal amputation in patients with a diabetic foot: reviewing 10 years experience.
  • Transmetatarsal Amputation: A Case Series and Review of the Literature
  • Transmetatarsal Amputation: A Case Series and Review of the Literature
  • Transmetatarsal Amputation
  • Trans-metatarsal amputation in patients with a diabetic foot: reviewing 10 years experience.

Demographic characteristics Transmetatarsal amputation patient's age, sex, and body mass index were documented. In addition, the following factors were recorded: Received Mar 28; Accepted May This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

This article has been cited by other articles in PMC. transmetatarsal amputation

Transmetatarsal Partial Foot Amputation

Abstract Foot ulceration is a major cause of morbidity amongst patients with diabetes. Soft tissue is the primary determinate for MT length. It is far better to have very short MTs and better padding than longer MT length and scarred, thin, or damaged tissue coverage.

One should cut the MT bones in a way that provides the partial foot a similar contour and shape to MT transmetatarsal amputation in a non-amputated foot.

transmetatarsal amputation

Typically, the transmetatarsal amputation MT is cut first, perpendicular to its axis in the ML plane, and beveled slightly to remove more bone on the plantar surface than dorsally. The 1 st MT is cut to match the length of the 2nd.

Predictors of Healing and Functional Outcome Following Transmetatarsal Amputations

However, it is beveled transmetatarsal amputation from the second with more bone removed medially than laterally, and more plantarly than dorsally. MTs 3, 4 and 5 are cut on a line that starts at the length of the 2nd MT but slopes proximally so that MTs 3, 4, and 5 are progressively shorter than transmetatarsal amputation 2nd MT.


All are cut to remove more bone laterally than medially, and more plantarly than dorsally. Skin incisions and flaps: The transmetatarsal amputation incisions are drawn out based on the available soft tissue, and the level of the MT bone cuts will also be based on the tissue available.

Identify the lateral malleolus, the lateral side of the 5th MT head, and the lateral aspect of the base of the 5th Transmetatarsal amputation.

Nonhealers underwent a mean SD of 4.

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