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Preoperative Doppler Assessment for Transmetatarsal Amputation

      Abstract

      A thorough preoperative vascular evaluation should be performed before the initiation of any lower extremity surgical intervention, but particularly in situations of diabetic foot reconstruction with compromised blood flow. The intended emphasis of this brief report is to provide the foot and ankle surgeon with an appreciation for the clinical vascular anatomy of the transmetatarsal amputation through a handheld Doppler examination.

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      References

        • Pollard J.
        • Hamilton G.A.
        • Rush S.M.
        • Ford L.A.
        Mortality and morbidity after transmetatarsal amputation: retrospective review of 101 cases.
        J Foot Ankle Surg. 2006; 45: 91-97
        • Blume P.
        • Salonga C.
        • Garbalosa J.
        • Pierre-Paul D.
        • Key J.
        • Gahtan V.
        • Sumpio B.E.
        Predictors for the healing of transmetatarsal amputations: retrospective study of 91 amputations.
        Vascular. 2007; 15: 126-133
        • Stone P.A.
        • Back M.R.
        • Armstrong P.A.
        • Flaherty S.K.
        • Keeling W.B.
        • Johnson B.L.
        • Shames M.L.
        • Bandyk D.F.
        Midfoot amputations expand limb salvage rates for diabetic foot infections.
        Ann Vasc Surg. 2005; 19: 805-811
        • Anthony T.
        • Roberts J.
        • Modrall J.G.
        • Huerta S.
        • Asolati M.
        • Neufeld J.
        • Parker B.
        • Yang W.
        • Sarosi G.
        Transmetatarsal amputation: assessment of current selection criteria.
        Am J Surg. 2006; 192: e8-e11
        • Glass H.
        • Rowe V.L.
        • Hood D.B.
        • Yellin A.E.
        • Weaver F.A.
        Influence of transmetatarsal amputation in patients requiring lower extremity distal revascularization.
        Am Surg. 2004; 70: 845-849
        • Toursarkissian B.
        • Hagino R.T.
        • Khan K.
        • Schoolfield J.
        • Shireman P.K.
        • Harkless L.
        Healing of transmetatarsal amputation in the diabetic patient: is angiography predictive?.
        Ann Vasc Surg. 2005; 19: 769-773
        • Sheahan M.G.
        • Hamdan A.D.
        • Veraldi J.R.
        • McArthur C.S.
        • Skillman J.J.
        • Campbell D.R.
        • Scovell S.D.
        • Logerfo F.W.
        • Pomposelli Jr., F.B.
        Lower extremity minor amputations: the roles of diabetes mellitus and timing of revascularization.
        J Vasc Surg. 2005; 42: 476-480
        • Wallace G.F.
        • Stapleton J.J.
        Transmetatarsal amputations.
        Clin Podiatr Med Surg. 2005; 22: 365-384
        • Ballard J.L.
        • Eke C.C.
        • Bunt T.J.
        • Killeen J.D.
        A prospective evaluation of transcutaneous oxygen measurements in the management of diabetic foot problems.
        J Vasc Surg. 1995; 22: 485-490
        • Armstrong D.G.
        • Lipsky B.A.
        Diabetic foot infections: stepwise medical and surgical management.
        Int Wound J. 2004; 1: 123-132
        • Cook K.D.
        Perioperative management of pedal amputations.
        Clin Podiatr Med Surg. 2005; 22: 329-341
        • Attinger C.E.
        • Cooper P.
        • Blume P.
        Vascular anatomy of the foot and ankle.
        Oper Tech Plast Reconstr Surg. 1997; 4: 183-198
        • Attinger C.E.
        • 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: 745-799
        • Attinger C.E.
        • Evans K.K.
        • 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: 261-293S
        • Taylor G.I.
        • Ives A.
        • Rumbolo P.M.
        Vascular territories.
        in: Mathes S.J. Plastic Surgery. Saunders Elsevier, Philadelphia2006: 317-364
        • Taylor G.I.
        The blood supply of the skin.
        in: Thome C.H. Lippincott Grabb and Smith's Plastic Surgery. Williams and Wilkins, Philadelphia2007: 33-41
        • Taylor G.I.
        • Palmer J.H.
        The vascular territories (angiosomes) of the body: experimental study and clinical applications.
        Br J Plast Surg. 1987; 40: 113-141
        • Taylor G.I.
        • Pan W.R.
        Angiosomes of the leg: anatomic study and clinical implications.
        Plast Reconstr Surg. 1998; 102: 599-616
        • Taylor G.I.
        The angiosomes of the body and their supply to perforator flaps.
        Clin Plast Surg. 2003; 30: 331-342
        • Ger R.
        • Angus G.
        • Scott P.
        Transmetatarsal amputation of the toe: an analytic study of ischemic complications.
        Clin Anat. 1999; 12: 407-411
      1. 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.