Amputation of the Foot or Toe
(Toe Amputation; Foot Amputation)En Español (Spanish Version)
Reasons for Procedure
Amputation is done to treat either gangrene or persistent pain. These conditions are most often caused by poor circulation, most often linked to:
- Complications of diabetes (most common reason)
- Bone infection ( osteomyelitis )
- Trauma (crush injury)
- Severe frostbite
- Buerger's disease
- Severe atherosclerosis
- Blood clots
- Vasospastic disorders such as lupus and scleroderma
Gangrene of Foot
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Risk Factors for Complications During the Procedure
What to Expect
Prior to Procedure
Your doctor will likely do at least some of the following:
- Blood tests
- X-ray of toe and foot
- Bone scan to see if the bone is infected
- A prolonged period of debridement, antibiotics, and wound care in an attempt to heal wounds medically
- Possible angioplasty or bypass procedures to improve the circulation
- Tests to evaluate blood circulation and help the surgeon determine how much of the foot or toe needs to be amputated:
- Arrange for a ride to and from the procedure
- Arrange for help at home after the surgery
- The night before, eat a light meal and do not eat or drink anything after midnight
- You may be asked to shower the morning of your procedure with a special antibacterial soap
Description of the Procedure
You will be given IV fluids and antibiotics. Your foot is washed with an antibacterial solution. The surgeon makes an incision into the skin, around the area to be removed. Blood vessels are tied off or cauterized (burned) to prevent bleeding.
After the foot or toe is removed, the ends of the bone(s) are smoothed with a special surgical rasp. The remaining skin and muscle flap are pulled over the open area and closed with stitches. A sterile dressing is placed over the incision.
If there is an active infection, tubes may be left in place to allow fluids to drain. The skin is not closed if there is an active infection. Instead, the area will be packed with a moist dressing, which is changed daily.
Amputation of Crushed Toe
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- Pain medications
- Possibly antibiotics
- Foot should be kept elevated
- The toe or foot is wrapped with a bulky dressing to protect it from trauma
How Long Will It Take?
Will It Hurt?
Anesthesia prevents pain during surgery.
- Difficulty healing
- Collection of blood (hematoma)
- Phantom limb pain (a painful sensation that the foot or toe is still there)
- Stump pain (severe pain in the remaining tissue)
- Continued spread of gangrene, requiring amputation of more areas of your foot, toes, or leg
- Depending on which toe has been removed, you may walk with a limp
Average Hospital Stay
- You'll be encouraged to get up and begin walking as soon as the wound allows.
- You may need to wear a cast, a special postoperative shoe, or a regular shoe with the foot box removed until the stitches are taken out.
- Stitches will be removed in about three weeks.
- You may be advised to begin an exercise, physical therapy, or rehabilitation program.
- You may need to be fitted with a prosthetic foot. Physical therapy will help you learn how to walk on it.
If you have diabetes, to reduce your risk for future problems:
- Ask your doctor about appropriate foot care
- Work to tightly control your blood sugar
- If you are a smoker, you should quit .
- You may need to take a blood thinner, such as aspirin .
Hopefully, the amputation will stop the spread of gangrene and will allow the remaining toes, foot, and leg to stay healthy.
Call Your Doctor If Any of the Following Occurs
- Signs of infection, including fever and chills
- Redness, warmth, swelling, increasing pain, excessive bleeding, or discharge at 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
- Cough, shortness of breath, chest pain, or severe nausea or vomiting
American Academy of Orthopaedic Surgeons
American Diabetes Association
Canadian Diabetes Association
The Canadian Orthopaedic Association
Armstrong DG, Lavery LA. Diabetic foot ulcers: prevention, diagnosis and classification. American Academy of Family Physicians website. Available at: http://www.aafp.org/afp/980315ap/armstron.html . Accessed June 9, 2008.
Canale ST, Daugherty K, Jones L eds. Campbell's Operative Orthopaedics . 10th ed. Philadelphia, PN: Mosby-Year Book; 2003.
Canale ST, Daugherty K, Jones L eds. Campbell's Operative Orthopaedics . 9th ed. Philadelphia, PN: Mosby-Year Book; 1998.
Sales CM, Goldsmith J, Veith FJ eds. Handbook of Vascular Surgery . Sudbury, MA: Quality Medical Publishing; 1996.
Townsend C, Beauchamp DR eds. Sabiston Textbook of Surgery . 17th ed. Oxford, UK: WB Saunders; 2004.
Townsend C, Beauchamp DR eds. Sabiston Textbook of Surgery . 16th ed. Oxford, UK: WB Saunders; 2001.
Last reviewed October 2007 by Ronald Nath, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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