Amputation is defined as a partial or full removal of a foot. Also known as lower extremity amputation (LEA) or partial foot amputation (PFA), a foot amputation is relatively common as a complication to diabetes, especially among the elderly when coupled with poor circulation. The ankle joint may or may not be involved in the amputation.
Common Types of Foot Amputation
- Syme's amputation - amputation at the ankle level
- Chopart amputation - (also known as Lisfranc or Ray) partial foot amputation involving removal of the forefoot and midfoot
- Partial foot amputations involving a number of approaches, and may save one or more toes, may occur on one side of a foot or transect or cross over a portion of the foot, depending on case scenario, patient condition and prognosis
Reasons for Foot Amputation
- Poor peripheral circulation, sometimes caused by diabetes
- Hardening of the arteries or atherosclerosis, a condition caused by thickening of artery walls
- Infection or gangrene
- Traumatic accidents
- Damaged blood vessels
In order to confirm that an amputation is necessary, you may undergo a number of tests that may include:
- Blood and culture studies
- x-rays of toes and foot
- Bone scan to determine if infection of the bone is present
- Angiogram - to check blood flow in your leg
- Arterial Doppler imaging or arteriography studies
You will be placed under general anesthesia during the surgical procedure so you'll be asleep. A foot amputation can be completed within an hour. During the procedure:
- A circular incision will be made in the skin and muscular tissues above the ankle joint.
- Blood vessels, nerves and bones are severed at the distal or lower end of the tibia. Blood vessels are tied off.
- The bone end is covered with a "flap" - often created with your own skin, muscle or other connective tissue
- Muscles are stitched together with large sutures
- The skin is closed with small sutures
- The stump is wrapped in a thick bandage - your bandage may be a hard cast or soft, depending on the condition of your leg upon amputation. If you had infection, a soft bandage is most often used, covered with an elastic bandage.
What to Expect
Your doctor may suggest that an artificial limb or prosthesis be fitted to your stump as soon as possible to aid in the recovery process. You can expect to stay in the hospital for 2 to 7 days, with an approximately six-week recovery period following the surgical procedure. You will undergo physical rehabilitation to help with gait training and to aid in your adaption of a prosthetic device for greater independence and mobility.