What are the clinical indications for 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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Candidates for TMA are chosen on the basis of limited irremediable tissue loss, typically occurring as a result of infection or ischemic changes in the foot. [3] The essential factor that must be taken into consideration is the individual patient's vascular sufficiency, which directly affects healing after amputation.

The clinical indications for TMA are as follows:

  • Chronic forefoot ulceration
  • Forefoot gangrene (multiple digits)
  • Combination of the above (potentially complicated by diabetes mellitus [4] )
  • Severe crushed forefoot (not salvageable)

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