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The Role of Revascularization in Transmetatarsal Amputations

Javier La Fontaine, DPM^*, Alex Reyzelman, DPM, Gary Rothenberg, DPM, Khalid Husain, DPM and Lawrence B. Harkless, DPM^||

^* Submitted during second-year residency, University of Texas Health Science Center at San Antonio, Podiatry Service, 7703 Floyd Curl Dr, San Antonio, TX 78284.
Submitted as Chief Resident, University of Texas Health Science Center at San Antonio, San Antonio, TX.
Submitted during first-year residency, University of Texas Health Science Center at San Antonio, San Antonio, TX.
Submitted as Diabetic Foot Fellow, University of Texas Health Science Center at San Antonio, San Antonio, TX.
^|| Professor, University of Texas Health Science Center at San Antonio, San Antonio, TX.

Abstract

Data from 37 patients who underwent a transmetatarsal amputation from January 1993 to April 1996 were reviewed. The mean age and diabetes duration of the subjects were 54.9 (± 13.2) years and 16.6 (± 8.9) years, respectively. The follow-up period averaged 42.1 (± 11.2) months. At the time of follow-up, 29 (78.4%) of the 37 patients still had foot salvage, 8 (21.6%) had progressed to below-the-knee amputation, and 15 (40.5%) had undergone lower-extremity revascularization. Twelve (80%) of the 15 revascularized patients preserved their transmetatarsal amputation level at a follow-up of 36.4 months. The authors concluded that at a maximum of 3 years follow-up after initial amputation, transmetatarsal amputation was a successful amputation level. (J Am Podiatr Med Assoc 91(10): 533-535, 2001)

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