title: Partial foot amputations in the combat wounded.
abstract: Throughout the current conflicts in Afghanistan and Iraq, there have been more than 1100 combat-related major limb amputations, with approximately 80% involving the lower extremity. There is, however, a paucity of data regarding the number of amputations below the level of the ankle. Although not as common, partial foot amputations, in the appropriate setting, offer a way to improve function and decrease energy consumption when compared to proximal amputations. Sound surgical tenets are prerequisite for successful outcomes when performing a distal amputation. Maintaining a robust soft tissue envelope allowing for tension-free wound closure is paramount in determining the feasibility of a partial foot amputation. Careful consideration of tendon balancing is also of utmost importance in avoiding common complications of contracture and deformity. Partial foot amputations present a viable surgical option for successful outcomes and maximization of patient function in the combat injured when certain criteria are met.
authors.affiliation: Department of Orthopedics and Rehabilitation, Orthopedic Surgery Service, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234, USA. Kevin.l.kirk@us.army.mil
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Kirk
authors.forename: Evan M
authors.initials: EM
authors.lastname: Jones
authors.forename: Benjamin Kyle
authors.initials: BK
authors.lastname: Potter
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Osborn
authors.forename: James R
authors.initials: JR
authors.lastname: Ficke
mesh_terms: D055826:Afghan Campaign 2001-; D000673:Amputation, Traumatic / Q000534:rehabilitation / Q000601:surgery*; D001753:Blast Injuries / Q000601:surgery*; D018409:Foot Injuries / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D054542:Iraq War, 2003-2011; D023821:Limb Salvage / Q000379:methods* / Q000534:rehabilitation; D008297:Male; D008889:Military Personnel; D009989:Orthotic Devices; D011183:Postoperative Complications / Q000628:therapy; D014481:United States; D055815:Young Adult