Foot amputation

Updated 2/19/2024
Amputated foot

A lower extremity amputation or foot amputation is a catchall term for surgical removal of all or part of the foot. It could mean a toe amputation, a partial foot amputation, a midfoot amputation, or even complete lower leg removal.

 

At University Foot & Ankle Institute (UFAI), we try to avoid amputation and start with conservative treatment options whenever possible. When amputation is necessary, we try to preserve as much bone, skin, soft tissue, and nerve tissue as possible.

What are the most common causes of foot amputation?

Traumatic injury accounts for about 45% of all amputations. A traumatic amputation may be caused by a motor vehicle, occupational or industrial accident, or combat injury.

 

About 54% of all surgical amputations result from complications of vascular diseases, such as diabetes and peripheral arterial disease (PAD). Damage to blood vessels or decreased blood flow makes it harder for your body to fight infections and heal itself and can also cause tissue death.

 

Other common causes of foot amputation include:

 

  • Diabetic foot ulcers
  • Gangrene
  • Peripheral arterial or vascular disease
  • Tumors
  • Traumatic injuries
  • Severe infection
  • Vascular surgery

 

If tissue destruction, infection, or disease affects a foot and makes it impossible to repair, you may require partial foot amputation to remove the dead or damaged tissue. Damage or disease that cuts off blood flow for an extended period of time (such as frostbite) can also require amputation.

 

Severe sepsis or blood poisoning can also cause tissue death — especially in the toes and feet.

 

Taking care of your general health and monitoring your feet regularly for injuries, blisters, ulcers, or signs of infection can avoid the need for amputation.

 

What are the types of lower limb amputation?

Whether you need a leg amputation, toe amputation, or any other type of amputation, it is best to know the details ahead of time. The healthcare professional responsible for your amputation should go over why you need an amputation and how much tissue will be removed.

 

While “lower extremity amputation” can also include transtibial amputation (below-knee amputation), knee amputation, or amputation at the hip, at UFAI we handle amputations of the foot and ankle.

 

Transmetatarsal Amputation  

During a transmetatarsal amputation (TMA), the bones in the ball of the foot, including the metatarsals, are amputated. There are five metatarsal bones in each foot, spanning the distance from the ankle to the toes.

 

TMA surgery is a routine procedure for treating a highly infected foot or a foot with inadequate blood flow

 

Symes Amputation 

In a Symes amputation, also called an ankle disarticulation, the patient’s foot is amputated, but the fat pad and soft tissue around the heel are saved so the patient may still walk.

 

Although the patient may stand on the remaining heel pad, excessive walking on the remaining limb is not advised. That is because the residual limb is shorter than the healthy one, which can cause gait irregularities and future posture issues.

 

What is recovery from foot amputation surgery like?

Recovery from amputation depends on the type of amputation you underwent.

 

In the hospital, your care team will be responsible for changing your wound dressings and teaching you proper wound care techniques for when you get home. Your healthcare provider will also monitor your wound healing progress.

 

You’ll be on antibiotics and painkillers after your procedure to prevent infection and make recovery more comfortable.

 

During recovery, you may experience phantom sensations (a feeling that the limb is still there), phantom pain (pain in the amputated limb), or grief over loss of a body part. We can recommend a therapist or specialist to help you navigate these experiences. Amputee support groups can also help you connect with other people who share your experience.

 

Ideally, the wound should fully heal in about four to eight weeks. But the physical and emotional adjustment to losing a limb can be a long process. 

 

Long-term foot amputation recovery and rehabilitation will include: 

  • Physical therapy exercises to improve muscle strength and control.
  • Activities to help restore the ability to carry out daily activities and promote independence.
  • Use of artificial limbs and assistive devices.
  • Mental health support — including counseling — to help with grief over the loss of the limb and adjustment to your new situation.

 

What are the options for foot prosthetics after foot amputation?

Innovative prosthetic device approaches continue to provide improved care options for patients. Working with a prosthetist, you’ll undergo assessment, examination, and design of a prosthesis followed by training with your new artificial limb.

 

With advances in techniques, materials, and components such as microprocessor knees and advanced feet and osseointegration, new opportunities continue to be developed to help people with limb loss resume their normal activities.

 

When should physical therapy begin after foot amputation?

Physical therapy and practice with the artificial limb may begin as soon as 10 to 14 days after surgery.

 

Physical therapy exercises focus on stretching, strengthening, and balance. These exercises will also give you time to practice with and adjust to your prosthetic limb or mobility aid. By the end, you should be able to return to your regular routine feeling confident and independent.

 

Follow your doctor’s recommendations!

For the best recovery, you should follow all of the surgeon’s post-operative instructions.

 

Only take the pain medicine your orthopedic surgeon has recommended. The risk of bleeding increases with any anticoagulant, including aspirin.

 

Your podiatrist may advise you to enter an inpatient rehabilitation center if you’re having issues with wound healing or are not progressing in regaining your mobility.

 

Your healthcare team’s primary goals will be healing, muscle recovery, prosthetic limb fitting, and ambulation. They will show you how to properly maintain your prosthesis.

 

As you can see, there are a few foot amputation types depending on the issue. Dealing with limb loss can be incredibly difficult, but it doesn’t have to limit your ability to live a full life. With time and proper treatment, you can make a full recovery. Contact University Foot & Ankle Institute’s expert podiatrists to learn your treatment and amputation options.

 

UFAI, Southern California’s largest foot and ankle wound care specialists

UFAI is nationally recognized for advanced foot care treatment far beyond what a primary care physician can provide. Our doctors have decades of combined experience managing the special circumstances surrounding all types of foot and ankle wound care. While our goal is to avoid amputation, UFAI’s orthopaedic surgeons are also fully trained and equipped to make your amputation as trauma-free as possible.

 

As one of Los Angeles’ largest podiatric healthcare practices, our wound care center offers multi-disciplinary medical care and diagnostic testing on-site, offering our patients convenience and peace of mind. For example, we can perform vascular testing at our clinics and have a vascular surgeon on our staff to treat patients with complex vascular diseases.

 

If you want to learn more about how UFAI can help you, we encourage you to schedule a consultation with one of our foot and ankle specialists by calling(877) 736-6001 or making an appointment online now.

 

University Foot and Ankle Institute is conveniently located throughout Southern California and the Los Angeles area. Our foot and ankle surgeons are available at locations in or near Santa Monica, Beverly Hills, West Los Angeles, Sherman Oaks, the San Fernando Valley, El Segundo, the South Bay, LAX, Calabasas, Agoura Hills, Westlake Village, Valencia, Santa Clarita, and Santa Barbara.

  • Dr. Gina Nalbandian, DPM

    Dr. Gina Nalbandian specializes in reconstructive and revisional foot and ankle surgery, foot and ankle trauma, sports medicine, lapiplasty, and limb salvage.

     

    While an undergrad, Gina volunteered at free clinics, hospitals and with the AIDS Project in Los Angeles, all the while exploring various careers in medicine. She also conducted and published her research in the lab on campus. “I soon found out that the lab life wasn’t for me, and I wanted a more hands-on approach to medicine,” she says.

     

    Dr. Nalbandian did her residency at St. Elizabeth’s Medical Center in Boston, which is affiliated with Tufts University. As a resident, she served an academic coordinator and chief resident.

     

    A resident of Sherman Oaks, Gina continues to volunteer her expertise with the Special Olympics, Happy Feet (providing foot care at homeless shelters), and the Boston Marathon.

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