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Journal of the American Podiatric Medical Association, Vol 83, Issue 2 101-107, Copyright © 1993 by American Podiatric Medical Association

JOURNAL ARTICLE

Panmetatarsal head resection. A viable alternative to the transmetatarsal amputation

JM Giurini, P Basile, JS Chrzan, GM Habershaw and BI Rosenblum
Department of Surgery, Harvard Medical School, Boston, MA.

While the transmetatarsal amputation has resulted in the salvage of numerous diabetic limbs, it remains an ablative procedure with both short- and long-term complications. The authors reviewed their experience with the panmetatarsal head resection as an alternative to the transmetatarsal amputation. A retrospective review was performed of all patients having undergone this procedure between May 1986 and November 1991. Thirty-seven procedures were performed; of these, 34 were evaluated. The average follow-up period was 20.9 months. Thirty-two feet showed primary healing while one showed delayed healing. One patient had local recurrence of the original ulceration. Primary healing was 94% while overall success was 97%. No patient required amputation of any kind. The authors conclude that the panmetatarsal head resection is a viable alternative to the transmetatarsal amputation in properly selected patients because it avoids many of the structural and biomechanical pitfalls of the transmetatarsal amputation.


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