Functional Outcome and Complications of Partial Foot Amputations in Diabetics

Aim: This study was conducted to test a protocol for the management of diabetics scheduled for partial foot amputation in a trial to improve the outcome. Methods: 60 patients underwent partial foot amputation with planned osseous resection and soft tissue coverage followed by postoperative pressure offloading between January 2002 and January 2006. Results: Amputations performed were ray in (51.6%), trans-metatarsal in (43.3%), Lisfranc’s in (3.3%), and Chopart’s in (1.7%). Coverage was done by planter flaps in (70%), combined flaps in (13.3%), skin grafts in (5%), and second intention in (11.7%). Complications were failure in (8.3%), adjacent limited arthritis or osteomyelitis in (11.7%), deformities in (15%), and instability in (11.7%). Further interventions were delayed primary closure in (6.7%), skin grafts in (5%), further partial foot amputation in (11.7%), and below knee amputation in (8.3%). The outcome was 53 partial foot amputees (88.3%) able to use their feet for one year without recurrent ulceration. Conclusion: The marked reduction in failure rate from (52%) in literature to (8.3%) with such protocol is encouraging to pay more interest in partial foot amputations as an alternative to higher ones.