Original communication Society for Vascular Surgery (concluded)| Volume 41, ISSUE 2, P184-189, February 1957

Evaluation of the transmetatarsal amputation in patients with diabetes mellitus

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      Among the 67 patients who had transmetatarsal amputation for neuropathy or infection (Group I) there were only 5 late failures requiring reamputation. Twenty-two of this group are known to be dead of causes not related to this surgery, and 29 are known to be well and using the foot—many of them well beyond the 5-year period.
      The arterial insufficiency group numbered 366, were older, and stayed longer in the hospital than Group I. Approximately one-third of these failed eventually. The incidence of failure was more closely related to the evaluation of the collateral circulation by the venous filling time and by other means than to the presence or absence of a popliteal pulse. Of course, only a few had pedal pulses. Sixty-one per cent of those who lived for 3 years had healed stumps at the end of that period, and 50 per cent of those who lived 5 years were similarly fortunate. The majority of failures occurred immediately postoperatively.
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        • Buerger Leo
        The Circulatory Disturbances of the Extremities.
        in: W. B. Saunders Co, Philadelphia, Pa1924: 163
        • McKittrick L.S.
        • McKittrick J.B.
        • Risley T.S.
        Transmetatarsal Amputation for Infection or Gangrene in Patients With Diabetes Mellitus.
        Ann. Surg. 1949; 130: 826-842