Predictors for the healing of transmetatarsal amputations: retrospective study of 91 amputations.
This retrospective study reviewed 80 consecutive patients (mean age 62 years; range 21-91 years) who underwent 91 transmetatarsal amputations (TMAs) between 1995 and 2003. The mean follow-up was 12 +/- 1.36 months. Sixty-two TMAs healed initially (group 1), whereas 29 TMAs did not heal by 3 months (group 2). At the final examination, in groups 1 and 2, 63 of 91 (69%) limbs were healed. Of the 28 limbs that did not heal, 25 of 28 (89%) required further proximal amputation. Initial healing correlated significantly with the ability to ambulate (p < .0001) and overall limb salvage (p < .0001). In group 1, 20 of 27 (74%) limbs that were revascularized healed (p = .0336). Nonhealing amputations were associated with end-stage renal disease (13 of 19; 68%) (p = .0209) and leukocytosis (13 of 19; 68%) (p = .0052).
Blume
Peter
P
Department of Vascular Surgery, Yale University School of Medicine, New Haven, CT 06515, USA. peter.b@snet.net
Salonga
Christine
C
Garbalosa
Juan
J
Pierre-Paul
Daphne
D
Key
Jonathon
J
Gahtan
Vivian
V
Sumpio
Bauer E
BE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000379:methods*; D005260:Female; D005528:Foot / Q000098:blood supply / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D023821:Limb Salvage / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*