Association between crural vessel patency and successful transmetatarsal amputation: a single centre experience
Year: 2018
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Transmetatarsal amputation (TMA) has a reputation for failure, centred around wound breakdown. No study has looked at the direct association between the patency of individual crural arteries and the healing of TMA. TMA relies on a posterior skin flap which derives its blood supply from the posterior tibial (PT) artery. We investigated the association between PT patency and achievement of successful TMA. METHODS: A retrospective review of all patients undergoing TMA for complications of peripheral arterial occlusive disease in a regional vascular tertiary referral centre over a 9 year period (2006-2015). TMA was considered successful by the absence of a higher-level amputation. Follow-up was for a minimum of 12 months. RESULTS: 24 patients (21 male; mean age 64 years) were studied. TMA was successful in 16 (67%). On statistical analysis, successful TMA was not significantly associated with vessel patency in either superficial femoral artery (SFA), or any single or combination of named crural artery. CONCLUSION: TMA healing can be achieved in the absence of a patent posterior tibial artery. We support the role of TMA in selected patients, given its benefits compared to transtibial amputation.
Source: South African Journal of Surgery
Authors: Dariush Kamali, Matthew Thomas, Peter van Loo, Ian Nichol
Institution: James Cook University Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W2890079262