Open transmetatarsal amputation in the treatment of severe foot infections

Joseph R. Durham, David M. McCoy, Alan Sawchuk, Joseph P. Meyer, Thomas H. Schwarcz, Jens Eldrup-Jorgensen, D. Preston Flanigan, James J. Schuler

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Severe forefoot infections may lead to limb loss, even if addressed aggressively. Infection or gangrene that compromises the plantar skin flap may preclude a standard transmetatarsal or midfoot amputation, thereby culminating in a below-knee amputation. We report a series of forefoot infections with loss of the distal plantar skin. Open or guillotine amputation at the mid-metatarsal level led to a high rate of healing and a durable stump, provided that the level of infection did not extend beyond the metatarsal heads. Wound closure was obtained by wound contracture alone or by use of partial-thickness skin grafting. Rehabilitation was dependable. The association of diabetes mellitus or gangrene did not adversely affect outcome. Open transmetatarsal amputation is a safe surgical option preferable to midfoot or below-knee amputation for the treatment of severe forefoot infection that does not extend proximally beyond the metatarsal heads.

Original languageEnglish
Pages (from-to)127-130
Number of pages4
JournalAmerican Journal of Surgery
Volume158
Issue number2
DOIs
StatePublished - 1989
Externally publishedYes

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Amputation
Foot
Metatarsal Bones
Infection
Gangrene
Knee
Therapeutics
Skin
Skin Transplantation
Wounds and Injuries
Contracture
Diabetes Mellitus
Rehabilitation
Extremities

ASJC Scopus subject areas

  • Surgery

Cite this

Durham, J. R., McCoy, D. M., Sawchuk, A., Meyer, J. P., Schwarcz, T. H., Eldrup-Jorgensen, J., ... Schuler, J. J. (1989). Open transmetatarsal amputation in the treatment of severe foot infections. American Journal of Surgery, 158(2), 127-130. https://doi.org/10.1016/0002-9610(89)90360-7

Open transmetatarsal amputation in the treatment of severe foot infections. / Durham, Joseph R.; McCoy, David M.; Sawchuk, Alan; Meyer, Joseph P.; Schwarcz, Thomas H.; Eldrup-Jorgensen, Jens; Flanigan, D. Preston; Schuler, James J.

In: American Journal of Surgery, Vol. 158, No. 2, 1989, p. 127-130.

Research output: Contribution to journalArticle

Durham, JR, McCoy, DM, Sawchuk, A, Meyer, JP, Schwarcz, TH, Eldrup-Jorgensen, J, Flanigan, DP & Schuler, JJ 1989, 'Open transmetatarsal amputation in the treatment of severe foot infections', American Journal of Surgery, vol. 158, no. 2, pp. 127-130. https://doi.org/10.1016/0002-9610(89)90360-7
Durham, Joseph R. ; McCoy, David M. ; Sawchuk, Alan ; Meyer, Joseph P. ; Schwarcz, Thomas H. ; Eldrup-Jorgensen, Jens ; Flanigan, D. Preston ; Schuler, James J. / Open transmetatarsal amputation in the treatment of severe foot infections. In: American Journal of Surgery. 1989 ; Vol. 158, No. 2. pp. 127-130.
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