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The Role of Revascularization in Transmetatarsal Amputations

Javier La Fontaine Submitted during second-year residency, University of Texas Health Science Center at San Antonio, Podiatry Service, 7703 Floyd Curl Dr, San Antonio, TX 78284.

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Alex Reyzelman Submitted as Chief Resident, University of Texas Health Science Center at San Antonio, San Antonio, TX.

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Gary Rothenberg Submitted during first-year residency, University of Texas Health Science Center at San Antonio, San Antonio, TX.

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Khalid Husain Submitted as Diabetic Foot Fellow, University of Texas Health Science Center at San Antonio, San Antonio, TX.

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Lawrence B. Harkless Professor, University of Texas Health Science Center at San Antonio, San Antonio, TX.

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Data from 37 patients who underwent a transmetatarsal amputation from January 1993 to April 1996 were reviewed. The mean age and diabetes duration of the subjects were 54.9 (± 13.2) years and 16.6 (± 8.9) years, respectively. The follow-up period averaged 42.1 (± 11.2) months. At the time of follow-up, 29 (78.4%) of the 37 patients still had foot salvage, 8 (21.6%) had progressed to below-the-knee amputation, and 15 (40.5%) had undergone lower-extremity revascularization. Twelve (80%) of the 15 revascularized patients preserved their transmetatarsal amputation level at a follow-up of 36.4 months. The authors concluded that at a maximum of 3 years follow-up after initial amputation, transmetatarsal amputation was a successful amputation level. (J Am Podiatr Med Assoc 91(10): 533-535, 2001)