What is transmetatarsal amputation (TMA)?

Updated: Apr 29, 2021
  • Author: Palaniappan Lakshmanan, MBBS, MS, AFRCS, FRCS(Tr&Orth); Chief Editor: Erik D Schraga, MD  more...
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Transmetatarsal amputation (TMA) is a relatively common operation that is performed to safeguard limb viability. [1] Originally used for trench foot, TMA now has widespread uses in both orthopedic and vascular surgery because it treats patients with infection of the forefoot, necrosis, gangrene, and diabetic neuropathy, who commonly develop ulcerations. Bernard and Heute first described TMA in 1855, but it was McKittrick et al in 1949 who used it as an alternative to higher amputations in patients with the above signs and symptoms. [2]

The aims of TMA are as follows:

  • To remove nonviable tissue so that the process of healing can take place
  • To maintain limb functionality by preserving the maximum amount of midfoot distal to the ankle joint; this implies maintaining maximum length distally, allowing a larger surface area for weightbearing and mobility

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