Retrospective review of forefoot amputations at a Veterans Affairs hospital and evaluation of post-amputation follow-up

Abstract 

Background

Forefoot amputations in diabetic and vascular patients often are followed by subsequent amputations. We evaluated the outcomes of forefoot amputations and the efficacy of our care in preventing subsequent amputations.

Material and Methods

Charts of all patients undergoing forefoot amputations were reviewed. Comorbid conditions, subsequent amputations, and the nature of pre- and post-amputation care were noted. A subset of patients followed more than 2 years post-amputation was studied to evaluate post-amputation care.

Results

Of the 81 patients, 26% underwent subsequent forefoot amputations and 37% underwent subsequent proximal amputations. Forty-one patients followed more than 2 years were divided into 2 groups: those followed closely by foot-care specialists and those followed by primary care providers. The former group experienced fewer amputations, but the difference was not statistically significant.

Conclusions

Previous forefoot amputation is a high-risk factor for repeat amputations. Our post-amputation care did not effectively reduce subsequent amputations.

Keywords: Forefoot amputation, Diabetes, Outcome