A retrospective study was performed on 26 patients who had undergone 27 digital amputations. All of the patients in the study had marked neuropathy. Sixty-five percent of the feet developed new ulcerations following initial hallux amputations, with 53% of the ulcerations occurring at distal digital sites. Fifty-three percent of the patients who had undergone hallux amputations required further amputations secondary to new ulcerations. In contrast, only 10% of the feet with initial lesser digit amputations developed new ulcerations. The authors discuss the biomechanics involved and the possible therapy for preventing these ulcerations and amputations.