Panmetatarsal head resection. A viable alternative to the transmetatarsal amputation

J Am Podiatr Med Assoc. 1993 Feb;83(2):101-7. doi: 10.7547/87507315-83-2-101.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Amputation
  • Diabetes Complications*
  • Female
  • Foot Diseases / surgery
  • Humans
  • Male
  • Metatarsal Bones / surgery*
  • Metatarsus / surgery
  • Middle Aged
  • Retrospective Studies