title: Transmetatarsal amputation in the setting of antiphospholipid antibody syndrome.
abstract: Antiphospholipid syndrome is a hypercoagulable disease that can present foot and ankle surgeons with a unique challenge in treating patients who present with thrombosis and ischemia despite having normal pedal pulses. Appropriate perioperative management is imperative in these patients, because limb- and life-threatening complications can occur postoperatively, despite aggressive anticoagulation. We present the case of a 46-year-old male who underwent a transmetatarsal amputation and, despite aggressive therapy, developed a myriad of complications postoperatively. At 10 months postoperatively, the patient was doing well in an accommodative orthotic with minimal pain while receiving continued aggressive therapy and follow-up examinations by a number of specialists to treat his antiphospholipid syndrome.
authors.affiliation: Highlands-Presbyterian/St. Luke's Podiatric Medicine and Surgery Residency Program, Denver, CO, USA.
authors.forename: Jacob M
authors.initials: JM
authors.lastname: McLeod
authors.forename: Charles O
authors.initials: CO
authors.lastname: Brantigan
authors.forename: Kristen
authors.initials: K
authors.lastname: Alix
authors.forename: Dustin L
authors.initials: DL
authors.lastname: Kruse
authors.forename: Paul A
authors.initials: PA
authors.lastname: Stone
mesh_terms: D000671:Amputation, Surgical / Q000379:methods*; D016736:Antiphospholipid Syndrome / Q000150:complications*; D001157:Arterial Occlusive Diseases / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000601:surgery*; D007871:Leg Ulcer / Q000209:etiology / Q000601:surgery*; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008682:Metatarsal Bones / Q000601:surgery*; D008875:Middle Aged