Trans-Metatarsal Amputation

Original Editor - User:Lucinda hampton/Lucinda hampton

Top Contributors - Lucinda hampton and Ewa Jaraczewska

Introduction

Transmetatarsal amputation (TMA) is common for gangrene and infection in diabetic and peripheral vascular disease patients.

TMA advantages over below-knee amputation:

Simpler procedure
Less blood loss
Preserves ankle joint
Potential for limb salvage and improved walking chances

TMA risks and complications:

Wound healing problems
Recurring infections
Wound separation
Hospital readmissions
Additional surgeries
Delayed walking
Possible need for higher-level amputation

Careful patient selection and amputation level choice are crucial. Large-scale studies on TMA complications for different surgical reasons are lacking.^[1]

Case Study

See Trans-metatarsal amputation: Amputee Case Study

Rehabilitation

Rehabilitation requires a coordinated approach from surgical planning through post-operative care

The process involves multiple phases, including post-operative care and prosthetic fitting
Various orthotic and prosthetic options are available for patients with trans-metatarsal amputations
There is little evidence supporting one orthotic or prosthetic option over another
Achieving desired functional outcomes can be challenging in these cases
The rehabilitation process likely involves addressing the patient's ability to perform daily activities.
Diabetes and peripheral neuropathy may impact the rehabilitation.^[2]^[3]

See Amputee Rehabilitation

References

↑ Plantz MA, Bergman R, Gerlach E, Mutawakkil M, Patel M, Kadakia AR. Comparing perioperative outcomes after transmetatarsal amputation in patients with or without peripheral vascular disease. Journal of Foot and Ankle Research. 2025 Mar;18(1):e70026.Available:https://onlinelibrary.wiley.com/doi/full/10.1002/jfa2.70026 (accessed 12.8.2025)
↑ Nather A, Wong KL. Distal amputations for the diabetic foot. Diabet Foot Ankle. 2013 Jul 16;4.
↑ Dillon MP 2010 'Partial Foot Amputation: Aetiology, Incidence, Complications, Prosthetic Intervention and a Characterisation of Gait' In: JH Stone, M Blouin, editors. International Encyclopaedia of Rehabilitation https://eprints.qut.edu.au/15779/22/Michael_Dillon_Thesis.pdf

[1] Plantz MA, Bergman R, Gerlach E, Mutawakkil M, Patel M, Kadakia AR. Comparing perioperative outcomes after transmetatarsal amputation in patients with or without peripheral vascular disease. Journal of Foot and Ankle Research. 2025 Mar;18(1):e70026.Available:https://onlinelibrary.wiley.com/doi/full/10.1002/jfa2.70026 (accessed 12.8.2025)

[2] Nather A, Wong KL. Distal amputations for the diabetic foot. Diabet Foot Ankle. 2013 Jul 16;4.

[3] Dillon MP 2010 'Partial Foot Amputation: Aetiology, Incidence, Complications, Prosthetic Intervention and a Characterisation of Gait' In: JH Stone, M Blouin, editors. International Encyclopaedia of Rehabilitation https://eprints.qut.edu.au/15779/22/Michael_Dillon_Thesis.pdf

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