Toe Amputations Explained Part One

Toe amputations are unfortunately all too common in diabetics.  This common procedure is performed for a wide variety of reasons, but in nearly all cases it is done to keep the rest of the foot and leg healthy and to prevent eventual blood poisoning that can threaten one's life.  As a protective procedure, toe amputation can be very important in the overall health of a diabetic.  Although preventative measures should prevent most of these cases, there are times that toe amputations are necessary and desired when treating diabetic foot infections.  Over the course of the next two weeks, I will discuss why and how this procedure is performed, and its long term implications for walking and shoe fitting.

Toe amputations are performed for a variety of reasons, and not just diabetic infections.  The most common reason for a toe amputation is indeed due to diabetic foot complications.  Another common reason for toe amputation is gangrene from poor circulation, which sometimes cannot be reversed even if circulation is restored to the rest of the leg and foot.  One other reason for toe amputation is irreparable damage from a mangling or crushing injury.  Finally, a less common reason is a painful toe that is severely deformed, not functional, and not easily reconstructed through reparative surgery.

In the case of a diabetic complication,  toe amputations are done because either the skin over the toe becomes irreparably damaged due to bacteria and gangrene that entered the body through a wound (usually caused by pressure on a contracted toe deformity), or the bone underneath becomes infected.  Bacteria release toxins which kill healthy tissue, and eventually the tissue death passes a sort of point of no return, where the skin cannot return back to health even with the best of wound care.  When the infection reaches bone, it compromises the health of the toe even further, and the risk that the infection can spread further up the foot increases.  Toe bone infections are difficult to treat with antibiotics given their limited blood supply and inability to absorb a medically significant amount of the antibiotic  It is easier and more effective in most cases to simply remove the infected bone from the body.  In many cases, the toe left over by simply removing internal bone is deformed, short, not functional, and is at risk for further complications.  By actually amputating part or all of the toe, the infection problem is solved and the likelihood that the tissue will become diseased following surgery is significantly decreased.

Simply put, toe amputations can stop further spread of infection, eliminate the deformity that led to the initial skin wound that allowed bacteria to enter the foot in the first place, and potentially save the rest of the foot, the leg, or even one's life.  Next week I will discuss the actual procedure, and how the foot fares without a toe or toes.

Until next time,
Scott R. Kilberg DPM

www.inpodiatrygroup.com - foot surgeon, podiatrist in Indianapolis
myachingfoot.blogspot.com -  foot pain explained
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