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Amputation of the Foot or Toe

(Toe Amputation; Foot Amputation)
  • Definition

    Surgical removal of a toe, foot, or part of a foot
  • Reasons for Procedure

    Amputation is most often done to:
    • Treat infections
    • Remove dead or damaged tissue due to gangrene or serious trauma
    Gangrene of Foot
    gangrene on foot
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  • Possible Complications

    Complications are rare, but no procedure is completely free of risk. If you are planning to have an amputation, your doctor will review a list of possible complications, which may include:
    • Difficulty healing
    • Infection
    • Stump pain—severe pain in the remaining tissue
    • Phantom limb pain—a painful sensation that the foot or toe is still there
    • Continued spread of gangrene, requiring amputation of more areas of your foot, toes, or leg
    • Bleeding
    • Nerve damage
    • Limp or trouble walking, depending on which toe or how much of the foot has been removed
    • Contracture deformity
    Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
  • What to Expect

    Prior to Procedure
    Before the surgery, your doctor may do some of the following:
    • Blood tests
    • X-ray of toe and foot
    • Bone scan to see if the bone is infected
    • Tests to evaluate blood circulation and help the doctor determine how much of the foot or toe needs to be amputated
    Talk to the doctor about the medications you are taking. You may need to stop taking some medications up to 1 week before the procedure.
    In the days leading up to your surgery:
    • Arrange for a ride to and from the hospital.
    • Arrange for help at home after the surgery.
    • The night before, eat a light meal. Do not eat or drink anything after midnight.
    • You may be asked to shower the morning of your procedure. You may be asked to use a special antibacterial soap.
    Anesthesia
    Based on your surgery and general health, you may have:
    • General anesthesia —You will be asleep.
    • Local anesthesia—The area that is being operated on will be numbed.
    • Spinal anesthesia —Medication is delivered to the spine to numb the lower body.
    Description of the Procedure
    You will be given IV fluids and antibiotics. Your foot will be washed with an antibacterial solution. The surgeon will make an incision into the skin around the area. The blood vessels will be tied off or sealed with an electrical current. This will prevent bleeding. The involved bones will be removed.
    The ends of the remaining bone(s) will be smoothed. The remaining skin and muscle will be pulled over the open area. It will be closed with stitches. A sterile dressing will then be placed over the incision.
    If there is an active infection, tubes may be left in place to allow fluids to drain. In some cases, the skin will not be closed but will instead be packed with a moist dressing.
    Amputation of Crushed Toe
    crush toe amputation
    Copyright © Nucleus Medical Media, Inc.
    Immediately After Procedure
    You will be taken to a recovery room. There, you will be monitored for any negative effects from the surgery or anesthesia. You will be given pain medicine. You may also receive more antibiotic medicines.
    How Long Will It Take?
    20-60 minutes
    How Much Will It Hurt?
    Anesthesia prevents pain during surgery. The area will be painful after the surgery. You will be given medication to help control the pain.
    Average Hospital Stay
    The usual length of stay is 2-7 days. Your doctor may choose to keep you longer if complications arise.
    Post-procedure Care
    At the Hospital
    • Your foot will be kept elevated.
    • The remaining toes or foot will be wrapped with a bulky dressing. This will protect it from injury.
    • You will be encouraged to get up and begin walking as soon as the wound allows.
    • A physical therapist will likely assist you in walking at first.
    At Home
    When you return home, do the following to help ensure a smooth recovery:
    • You may be advised to begin an exercise, physical therapy, or rehabilitation program.
    • Be sure to follow your doctor’s instructions .
  • Call Your Doctor

    After you leave the hospital, contact your doctor if any of the following occurs:
    • Signs of infection, including fever and chills
    • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
    • Chalky white or blackish appearance of foot, other toes, or leg
    • Decreased sensation, numbness, or tingling in the rest of your foot, toes, or leg
    • Nausea and/or vomiting that you cannot control with the medications you were given after surgery, or that persist for more than one day after discharge from the hospital
    • Pain that you cannot control with the medications you have been given
    • Cough, shortness of breath, or chest pain
    • Joint pain, fatigue, stiffness, rash, or other new symptoms
    In case of an emergency, call for emergency medical services right away.
  • RESOURCES

    American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org

    American Diabetes Association http://www.diabetes.org

    CANADIAN RESOURCES

    Canadian Diabetes Association http://www.diabetes.ca

    The Canadian Orthopaedic Association http://www.coa-aco.org

    References

    Armstrong DG, Lavery LA. Diabetic foot ulcers: prevention, diagnosis and classification. Am Fam Physician. 1998 Mar 15;57(6):1325-1332. Available at: http://www.aafp.org/afp/980315ap/armstron.html. Accessed December 4, 2014.

    Baima J, Trovato M, Hopkins M, deLateur B. Achieving Functional Ambulation in a Patient with Chopart Amputation. American Journal of Physical Medicine & Rehabilitation. 2008;87(6):510-513.

    Parrett B, Pribaz J, Matros E, Przylecki W, Sampson C, Orgill D. Risk Analysis for the Reverse Sural Fasciocutaneous Flap in Distal Leg Reconstruction. Plastic and Reconstructive Surgery. 2009;123(5):1499-1504.

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