Panmetatarsal head resection. A viable alternative to the transmetatarsal amputation.
While the transmetatarsal amputation has resulted in the salvage of numerous diabetic limbs, it remains an ablative procedure with both short- and long-term complications. The authors reviewed their experience with the panmetatarsal head resection as an alternative to the transmetatarsal amputation. A retrospective review was performed of all patients having undergone this procedure between May 1986 and November 1991. Thirty-seven procedures were performed; of these, 34 were evaluated. The average follow-up period was 20.9 months. Thirty-two feet showed primary healing while one showed delayed healing. One patient had local recurrence of the original ulceration. Primary healing was 94% while overall success was 97%. No patient required amputation of any kind. The authors conclude that the panmetatarsal head resection is a viable alternative to the transmetatarsal amputation in properly selected patients because it avoids many of the structural and biomechanical pitfalls of the transmetatarsal amputation.
Giurini
J M
JM
Department of Surgery, Harvard Medical School, Boston, MA.
Basile
P
P
Chrzan
J S
JS
Habershaw
G M
GM
Rosenblum
B I
BI
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D048909:Diabetes Complications; D005260:Female; D005534:Foot Diseases / Q000601:surgery; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000601:surgery*; D008684:Metatarsus / Q000601:surgery; D008875:Middle Aged; D012189:Retrospective Studies