Mortality and morbidity after transmetatarsal amputation: Retrospective review of 101 cases

Jason Pollard, Graham A. Hamilton, Shannon M. Rush, Lawrence A. Ford

Research output: Contribution to journalArticlepeer-review

99 Scopus citations


Medical records were reviewed for 90 patients (101 amputations) (mean age 64.3 years, range 39 to 86 years) who underwent transmetatarsal amputation (TMA). The mean follow-up period, excluding those patients who either died or went on to a more proximal amputation less than 6 months after TMA, was 2.1 years. Patients were examined for any postoperative complications associated with TMA. Complications were defined as hospital mortality occurring less than 30 days postoperatively; stump infarction with or without more proximal amputation; postoperative infection; chronic stump ulceration; stump deformity in any of 3 cardinal planes; wound dehiscence; equinus and calcaneus gait. An uncomplicated outcome was defined as the absence of all these complications and an ability to walk on the residuum with a diabetic shoe and filler after a minimum follow-up of 6 months. The χ 2 tests of association were used to determine whether diabetes, a palpable pedal pulse, coronary artery disease, end-stage renal disease, cerebral vascular accident, or hypertension were predictive of or associated with healing. A documented palpable pedal pulse was a predictor of healing (P = .0567) and of not requiring more proximal amputation (P = .03). End-stage renal disease predicted nonhealing (P = .04). A healed stump was achieved in 58 cases (57.4%). Postsurgical complications developed in 88 cases (87.1%). Two patients died within 30 days postoperatively. These data suggest that TMA is associated with high complication rates in a diabetic and vasculopathic population.

Original languageEnglish (US)
Pages (from-to)91-97
Number of pages7
JournalJournal of Foot and Ankle Surgery
Issue number2
StatePublished - Mar 2006
Externally publishedYes


  • Amputation
  • Diabetic foot
  • End-stage renal disease
  • Gangrene
  • Transmetatarsal

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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