When there is poor circulation to the lower extremities, serious tissue damage can occur. Vascular conditions can lead to gangrene, infection, necrosis and other detrimental tissue problems in the foot. To protect the connected appendage and health of the patient, foot or partial leg amputation can be required. One option can be transmetatarsal amputation (TMA), which allows for a partial amputation of the forefoot instead of complete above or below the knee amputation.
TMA is an alternative to amputation of the lower leg when severe vascular issues have caused tissue degradation. The main advantage for the patient is the ability to maintain use of their leg. With TMA, the minimal amount of tissue is removed, preserving enough of the foot structure to allow for weight-bearing movement. This procedure is most often used in diabetic patients that have forefoot gangrene or ulceration. It can also be considered for severe injuries to the forefoot or in other vascular conditions that have caused forefoot tissue decline.
TMA and Vascular Integrity
To ensure a TMA is possible, it is vital to preserve vascular integrity for healing. The remaining tissue, bone and skin must have proper circulation from the vascular system to heal. A vascular surgeon is integral to TMA, determining whether the vascular system can support the healing process and prevent further deterioration of the tissue in the foot. A vascular specialist is also instrumental in revascularization that is vital to protect the health of the extremities and prevent the need for complete amputation.
Whenever possible, transmetatarsal amputation can be advantageous over complete amputation of the foot or leg. Patients facing partial or complete leg or foot amputation due to tissue deterioration should seek the expertise of a vascular surgeon to determine whether TMA is an option to preserve their mobility.
Posted on behalf of:
Alan Benvenisty, MD
1090 Amsterdam Avenue
New York, NY 10025