Home Forums Marketplace Table of Contents Events Member List Site Map Register Mark Forums Read



Welcome to the Podiatry Arena forums, for communication between foot health professionals about podiatry and related topics.

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members (PM), upload content, view attachments, receive a weekly email update of new discussions, earn CPD points and access many other special features. Registered users do not get displayed the advertisments in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

If you have any problems with the registration process or your account login, please contact contact us.


Tags: ,

Predictors of healing and functional outcome following transmetatarsal amputations

Reply
Submit Thread >  Submit to Digg Submit to Reddit Submit to Furl Submit to Del.icio.us Submit to Google Submit to Yahoo! This Submit to Technorati Submit to StumbleUpon Submit to Spurl Submit to Netscape  < Submit Thread
 
Thread Tools Display Modes
  #1  
Old 16th November 2011, 01:14 PM
NewsBot's Avatar
NewsBot NewsBot is offline
The Admin that posts the news.
 
About:
Join Date: Jan 2006
Location: The Zoo, where all good monkeys should be
Posts: 20,395
Join Date: Jan 2006
Marketplace reputation 53% (0)
Thanks: 23
Thanked 789 Times in 640 Posts
Default Predictors of healing and functional outcome following transmetatarsal amputations

Podiatry Arena members do not see these ads
Predictors of healing and functional outcome following transmetatarsal amputations.
Landry GJ, Silverman DA, Liem TK, Mitchell EL, Moneta GL.
Arch Surg. 2011 Sep;146(9):1005-9.
Quote:
OBJECTIVES:
To evaluate factors that predict healing and to assess functional outcome and survival following transmetatarsal amputations (TMAs) for forefoot gangrene.

DESIGN:
Retrospective case-control study.

SETTING:
University hospital.

PATIENTS:
All patients undergoing TMA from January 1, 2004, through December 31, 2010.

INTERVENTION:
Transmetatarsal amputations performed in all patients.

MAIN OUTCOME MEASURES:
Transmetatarsal amputation healing, ambulation, living status, and survival. Demographic characteristics, preoperative vascular status, and perioperative variables were analyzed as predictor variables. Univariate and multivariate analyses were performed to determine predictors of healing and survival.

RESULTS:
Sixty-two TMAs were performed in 57 patients. Healing occurred in 33 TMAs (53%), with 22 TMAs (35%) in patients who proceeded to below-knee amputation and 7 TMAs (11%) in patients who died without healing. No demographic or perioperative variables significantly predicted healing. Independent ambulation was achieved in 24 patients with healed TMAs (73%) but in only 4 patients with nonhealed TMAs (14%) (P < .001). Mean survival was 16.5 months (range, 0-94 months), with no difference between patients with healed and those with nonhealed TMA. Significant predictors of mortality were dialysis-dependent renal failure (odds ratio, 4.85; 95% confidence interval, 1.01-23.30) (P = .047), nonindependent living (17.80; 3.03-104.80) (P = .001), and need for preoperative revascularization (4.80; 1.24-18.50) (P = .02).

CONCLUSIONS:
Transmetatarsal amputations have low healing rates, and patient demographic characteristics and preoperative assessment do not help predict healing. Transmetatarsal amputation healing, however, significantly predicts subsequent ambulatory status and should be pursued in patients with good rehabilitation potential.
Reply With Quote
Sponsored Links
  #2  
Old 2nd December 2015, 03:14 PM
NewsBot's Avatar
NewsBot NewsBot is offline
The Admin that posts the news.
 
About:
Join Date: Jan 2006
Location: The Zoo, where all good monkeys should be
Posts: 20,395
Join Date: Jan 2006
Marketplace reputation 53% (0)
Thanks: 23
Thanked 789 Times in 640 Posts
Default Re: Predictors of healing and functional outcome following transmetatarsal amputations

Outcomes of Chopart Amputation in a Tertiary Referral Diabetic Foot Clinic: Data From a Consecutive Series of 83 Hospitalized Patients.
Faglia E et al
J Foot Ankle Surg. 2015 Nov 24
Quote:
The purpose of the present retrospective study was to evaluate the outcomes (ie, ulcer recurrence, major amputation, death) in diabetic patients undergoing Chopart amputation because of deep infection or gangrene extending to the midfoot. From 2009 to 2011, 83 patients, aged 71.4 ? 9.3 years, underwent a midtarsal amputation and were followed up until December 31, 2012 (mean follow-up 2.8 ? 0.8 years). Of the 83 patients, 26 were female, 61 required insulin, 47 had renal insufficiency, 19 underwent hemodialysis, 65 had hypertension, 34 had a history of cardiac disease, and 4 had a history of stroke. Chopart amputation was performed in 38 patients (45.8%) with gangrene, 31 (37.4%) with abscess, and 14 (16.9%) with osteomyelitis. Urgent surgery was performed in 56 patients (67.5%). Effective revascularization was performed in 64 patients (77.1%) patients. Of the 83 patients, 47 had healed at a mean period of 164.7 (range 11 to 698) days. Ulcer recurrence developed in 15 patients (31.9%). A major amputation was necessary in 23 patients (27.7%), with an annual incidence of 13.0%. None of the included variables on logistic regression analysis was significantly associated with proximal amputation. Of the 83 patients, 38 (45.8%) died, with an annual incidence of 25.8%. On logistic regression analysis, age (odds ratio [OR] 1.11, 95% confidence interval [CI] 1.01 to 1.16), history of stroke (OR 9.94, 95% CI 3.16 to 31.24), and urgent surgery (OR 2.60, 95% CI 1.14 to 5.93) were associated with mortality. Chopart amputation represents the last chance to avoid major amputation for diabetic patients with serious foot complications. Our success rate was great enough to consider Chopart amputation a viable option for limb salvage in this high-risk population.
Thread Starter
Reply With Quote
  #3  
Old 31st January 2016, 07:39 PM
NewsBot's Avatar
NewsBot NewsBot is offline
The Admin that posts the news.
 
About:
Join Date: Jan 2006
Location: The Zoo, where all good monkeys should be
Posts: 20,395
Join Date: Jan 2006
Marketplace reputation 53% (0)
Thanks: 23
Thanked 789 Times in 640 Posts
Default Re: Predictors of healing and functional outcome following transmetatarsal amputations

Functional outcomes of transmetatarsal amputation in the diabetic foot: timing of revascularization, wound healing and ambulatory status.
Mandolfino T et al
Updates Surg. 2016 Jan 29
Quote:
Transmetatarsal amputation (TMA) is an effective surgical approach to treat forefoot infection and gangrene in diabetic patients. However, a high rate of complications and failure to heal require reamputation in a large number of cases. We analysed the outcomes of TMA to define the role of revascularization, wound healing and ambulatory status. From January 2008 to January 2013, 218 diabetic patients with foot infection and gangrene, submitted to TMA associated to revascularization were followed until healing, amputation or death. Revascularization was done in 202 (92 %) cases. In 16 (7 %) no revascularization was required. The TMA was closed in 135 (62 %) and left open in 83 (38 %) cases. The reamputation rate was 34 % and major amputation 12.6 % at 1-year follow-up. Patient following ranged 2-30 months with a mean of 15 months. The functional outcomes, living at home and ambulation outdoors, were 60 and 36 % at hospital discharge after TMA, 81 and 77 % at 1-year follow-up. TMA associated to revascularization can provide an effective limb salvage and functional results in diabetic patients with forefoot tissue loss and infection.
Thread Starter
Reply With Quote
Reply



Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts
vB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Forum Jump

Translate This Page

Similar Threads
Thread Thread Starter Forum Replies Last Post
Predictors of diabetic foot ulcers & infections NewsBot Diabetic Foot & Wound Management 42 20th August 2016 12:08 AM
Predictors of foot ulceration in patients with rheumatoid arthritis NewsBot General Issues and Discussion Forum 4 16th August 2015 01:46 AM
Predictors of overuse and foot/leg injuries Dean Hartley Biomechanics, Sports and Foot orthoses 19 23rd December 2009 11:10 PM
Height is a predictor of diabetes amputations NewsBot Diabetic Foot & Wound Management 1 15th August 2006 02:20 AM
Total contact casting in minor amputations NewsBot Diabetic Foot & Wound Management 0 7th April 2006 07:20 AM


New To Site? Need Help?

Finding your way around:

Browse the forums.

Search the site.

Browse the tags.

Search the tags.


All times are GMT -7. The time now is 03:11 AM.