Transmetatarsal Amputation Results in Higher Frequency of Revision Surgery and Higher Ambulation Rates Than Below- Knee Amputation

Autor: Conner D. Trimm BS, Angel Ordaz MD, Jason M. Pedowitz, Ian M. Foran MD
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Foot & Ankle Orthopaedics, Vol 7 (2022)
Druh dokumentu: article
ISSN: 2473-0114
24730114
DOI: 10.1177/2473011421S00978
Popis: Category: Diabetes; Midfoot/Forefoot; Trauma; Other Introduction/Purpose: The level of amputation in patients with severe lower extremity pathology often presents a challenge. Surgeons are often confronted with deciding between a transmetatarsal amputation (TMA) or below-knee amputation (BKA). Certainly, in cases where patients are candidates for a TMA, the decision might seem rather straightforward. However, the literature has demonstrated that minor foot amputations, like TMAs, often have high rates of revision and often necessitate a higher level of amputation. This study compared revision rates, need for higher level of amputation, post-operative ambulatory rates, and the demographics between patients undergoing either TMA or BKA. Methods: This was a retrospective analysis of patients who underwent BKA or TMA and received follow-up care at a single academic medical center from January of 2013 to May of 2021. Demographic and medical historical data was collected and compared between patients undergoing BKA or TMA. A binary logistic regression model was used to evaluate independent predictors for necessitation of revision surgery and/or higher levels of amputation between the two groups. Secondary outcomes included hospital length of stay, as well as ambulatory and wound status at last patient follow-up. Statistical significance was defined as p
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