Abstract

KAMALI, Dariush; THOMAS, Matthew; VAN LOO, Peter  and  NICHOL, Ian. Association between crural vessel patency and successful transmetatarsal amputation: a single centre experience. S. Afr. j. surg. [online]. 2018, vol.56, n.2, pp.50-53. ISSN 2078-5151.  http://dx.doi.org/10.17159/2078-5151/2018/v56n2a2351.

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.

Keywords : Transmetatarsal amputation; Diabetes Mellitus; Crural artery; Angioplasty.

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