Journal of Foot and Ankle Surgery
Volume 49, Issue 1 , Pages 101-105 , January 2010

Preoperative Doppler Assessment for Transmetatarsal Amputation

  • Christopher E. Attinger, MD

      Affiliations

    • Professor, Department of Plastic Surgery, Georgetown University School of Medicine, Washington, D.C.; Medical Director, The Center for Wound Healing, Georgetown University Hospital, Washington, D.C.
    • ,
  • Andrew J. Meyr, DPM

      Affiliations

    • Assistant Professor, Department of Podiatric Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA
    • Corresponding Author InformationAddress correspondence to: Andrew J. Meyr, DPM, TUSPM Department of Surgery, 8th at Race St, Philadelphia, PA 19107.
    • ,
  • Sarah Fitzgerald, DPM

      Affiliations

    • Resident, Washington Hospital Center Podiatric Surgical Residency Program, Washington, D.C.
    • ,
  • John S. Steinberg, DPM

      Affiliations

    • Assistant Professor, Department of Plastic Surgery, Georgetown University School of Medicine, Washington, D.C.

References 

  1. Pollard J, Hamilton GA, Rush SM, Ford LA. Mortality and morbidity after transmetatarsal amputation: retrospective review of 101 cases. J Foot Ankle Surg. 2006;45(2):91–97
  2. Blume P, Salonga C, Garbalosa J, Pierre-Paul D, Key J, Gahtan V, et al. Predictors for the healing of transmetatarsal amputations: retrospective study of 91 amputations. Vascular. 2007;15(3):126–133
  3. Stone PA, Back MR, Armstrong PA, Flaherty SK, Keeling WB, Johnson BL, et al. Midfoot amputations expand limb salvage rates for diabetic foot infections. Ann Vasc Surg. 2005;19(6):805–811
  4. Anthony T, Roberts J, Modrall JG, Huerta S, Asolati M, Neufeld J, et al. Transmetatarsal amputation: assessment of current selection criteria. Am J Surg. 2006;192(5):e8–e11
  5. Glass H, Rowe VL, Hood DB, Yellin AE, Weaver FA. Influence of transmetatarsal amputation in patients requiring lower extremity distal revascularization. Am Surg. 2004;70(10):845–849
  6. Toursarkissian B, Hagino RT, Khan K, Schoolfield J, Shireman PK, Harkless L. Healing of transmetatarsal amputation in the diabetic patient: is angiography predictive?. Ann Vasc Surg. 2005;19(6):769–773
  7. Sheahan MG, Hamdan AD, Veraldi JR, McArthur CS, Skillman JJ, Campbell DR, et al. Lower extremity minor amputations: the roles of diabetes mellitus and timing of revascularization. J Vasc Surg. 2005;42(3):476–480
  8. Wallace GF, Stapleton JJ. Transmetatarsal amputations. Clin Podiatr Med Surg. 2005;22(3):365–384
  9. Ballard JL, Eke CC, Bunt TJ, Killeen JD. A prospective evaluation of transcutaneous oxygen measurements in the management of diabetic foot problems. J Vasc Surg. 1995;22(4):485–490
  10. Armstrong DG, Lipsky BA. Diabetic foot infections: stepwise medical and surgical management. Int Wound J. 2004;1(2):123–132
  11. Cook KD. Perioperative management of pedal amputations. Clin Podiatr Med Surg. 2005;22(3):329–341
  12. Attinger CE, Cooper P, Blume P. Vascular anatomy of the foot and ankle. Oper Tech Plast Reconstr Surg. 1997;4:183–198
  13. Attinger CE, Cooper P, Blume P, Bulan E. The safest surgical incisions and amputations applying the angiosome principles and using the Doppler to assess the arterial-arterial connections of the foot and ankle. Foot Ankle Clin. 2001;6(4):745–799
  14. Attinger CE, Evans KK, Bulan E, Blume P, Cooper P. Angiosomes of the foot and ankle and clinical implications for limb salvage: reconstruction, incisions, and revascularization. Plast Reconstr Surg. 2006;117(suppl 7):261–293S
  15. Taylor GI, Ives A, Rumbolo PM. Vascular territories. In:  Mathes SJ editors. Plastic Surgery. Philadelphia: Saunders Elsevier; 2006;p. 317–364
  16. Taylor GI. The blood supply of the skin. In:  Thome CH, Lippincott  editor. Grabb and Smith's Plastic Surgery. Philadelphia: Williams and Wilkins; 2007;p. 33–41
  17. Taylor GI, Palmer JH. The vascular territories (angiosomes) of the body: experimental study and clinical applications. Br J Plast Surg. 1987;40:113–141
  18. Taylor GI, Pan WR. Angiosomes of the leg: anatomic study and clinical implications. Plast Reconstr Surg. 1998;102(3):599–616
  19. Taylor GI. The angiosomes of the body and their supply to perforator flaps. Clin Plast Surg. 2003;30(3):331–342
  20. Ger R, Angus G, Scott P. Transmetatarsal amputation of the toe: an analytic study of ischemic complications. Clin Anat. 1999;12(6):407–411
  21. Sarrafian SK. Angiology. In Anatomy of the Foot and Ankle. Descriptive, Topographic, Functional, pp 261–312, edited by SK Sarrafian, J.B. Lippincott Company, Philadelphia, 1983.

 Financial Disclosure: None reported.

 Conflict of Interest: None reported.

PII: S1067-2516(09)00307-X

doi: 10.1053/j.jfas.2009.07.022

Journal of Foot and Ankle Surgery
Volume 49, Issue 1 , Pages 101-105 , January 2010

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