The transmetatarsal amputation technique: Explained

stretching foot on ball

Sometimes the best way to prevent your body from being further affected by a medical condition is to remove the problem area. That’s what amputation does.

Transmetatarsal amputation is a surgery that removes damaged parts of the forefoot in an effort to save the rest of the extremity. It helps to salvage as much of the length of the limb as possible as well as the functional ankle joints. It can be beneficial when compared to hindfoot and below-knee amputations as it helps preserve the patient’s ability to bear weight on the foot for mobility.

While the word “amputation” can sound scary, it can bring some comfort if you know what to expect beforehand. We’ll talk about what’s involved in the technique of a transmetatarsal amputation procedure as well as why it might be needed. We’ll also cover what the recovery process looks like through Ability KC’s limb loss rehabilitation services.

What you need to know about the transmetatarsal amputation technique

While the technique of an amputation involves a lot of medical and anatomy terms, learning about what occurs during the procedure can bring comfort in understanding what will be occurring while you’re under anesthesia. It will also give you a better idea of how the foot will be different after the surgery so you’re not caught off guard.

A transmetatarsal amputation, or TMA, removes the distal portion of metatarsals. It involves creating a standard fish mouth incision close to the infected area on the dorsal area, or the top of the foot, making the dorsal flap. Hemostasis is done to help stop bleeding. The infected tissue is removed by cutting off the metatarsals, which are part of the bones located in the midfoot. When they are cut off, the ends are rounded out. Then a plantar incision is made on the bottom of the foot, making the plantar flap. All the exposed tendons are removed before the wound is closed.

If the foot is severely infected, the incision may be left open to heal and packed with medical bandages. Without infection, the incision will be closed with staples or stitches. 

Why you may need to have a transmetatarsal amputation

Your healthcare provider may recommend a transmetatarsal amputation to maintain as much of the limb’s function as possible if you have tissue that’s interfering with the healing process of an injury or condition. 

While there are several reasons for poor blood flow, injury or infection that can lead to a TMA, here are two of the most common reasons why people may undergo transmetatarsal amputation:

  • Diabetic complications — Neuropathy and peripheral artery disease are common in people with diabetes, and they can both interfere with the blood flow to the feet, causing ulcers and infections. The TMA removes the damaged tissue so that only the healthy tissue remains.
  • Gangrene — When there’s an infection, such as trench foot, or a severe lack of blood flow, the foot can develop dead tissue, known as gangrene, or edematous myonecrosis. It can cause severe pain and skin discoloration, which is often followed by a discharge and numbness. TMA removes the dead tissue to reduce the risk of further issues in the extremity.

According to research, the most common reasons for a TMA are:

  • Dry gangrene (44%)
  • Soft tissue infection (34%)
  • Foot ulcer (24%)
  • Prior toe amputation that didn’t properly heal (22%)

Ability KC can help you with the recovery process after transmetatarsal amputation

We understand that an amputation is a big life change. We want to help you navigate it by helping you be as mobile on your foot as possible.

Any sort of major surgery such as an amputation will require proper aftercare to move you along the recovery process, especially when it affects your ability to stand and walk. Our limb loss rehabilitation services will guide you through the recovery journey and help you gain back your independence by learning how to adapt to challenges brought on by the amputation. It can include intensive outpatient rehabilitation services, goal-based group therapies and interest-based resources.

Following an amputation on the foot, rehabilitation will focus on helping you regain your physical functions and learn to adapt your movements with your amputation. It can even include the option of getting you back behind the wheel with our driving rehabilitation program using assistive technology.

Ability KC is a designated Comprehensive Outpatient Rehabilitation Facility (CORF) with a Commission on Accreditation of Rehabilitation Facilities (CARF) accreditation. Contact our team today for more information or to schedule an initial appointment.