Reoperation and Reamputation Rates After Hallux Amputations versus Partial First-Ray Amputations.

Background: Foot infections are a common condition that foot and ankle providers treat. For patients who require an amputation, surgeons must decide what level of amputation to perform based on the extent of infection, soft-tissue viability, and the biomechanics of the foot. Although the literature has shown the high risk of repeated ulceration and amputation after a foot ulcer, there has been little published comparing partial first-ray amputation with hallux amputation.

Methods: The present study looked at reoperation and reamputation rates in 295 patients with either a partial first-ray amputation or a hallux amputation for treatment of infection.

Results: Almost half of both groups required a reoperation: 41.1% and 42.9% in the hallux and partial first-ray amputation groups, respectively. There was a 31.9% distal amputation rate in the hallux amputation group and a 27.9% rate in the partial first-ray amputation group. There was found to be a 10.6% and 16.9% major amputation rate in the hallux amputation and partial first-ray amputation groups, respectively. We found no statistically significant differences between these two groups regarding reoperation rates and distal or major amputations.

Conclusions: Either procedure is appropriate for infections of the first ray, and the level of amputation should be determined based on the extent of the infection and soft-tissue coverage.