From the Guidelines
A transmetatarsal amputation surgery typically takes between 1 to 2 hours to complete. This timeframe includes the surgical procedure itself, which involves removing the forefoot at the level of the metatarsal bones while preserving the midfoot and hindfoot. The exact duration can vary based on several factors including the patient's specific anatomy, the reason for amputation (such as infection, gangrene, or trauma), the surgeon's experience, and whether any complications arise during the procedure 1. Additional time may be needed if the surgery involves debridement of infected tissue, vascular procedures to improve blood flow, or complex wound closure techniques.
Key Considerations
- The surgical time does not include the pre-operative preparation or post-operative recovery in the operating room, which would add approximately another hour to the total time the patient spends in the surgical suite.
- The goal of the surgery is to provide a functional foot, and the surgeon should consider the need to balance preservation of tissue with the amputation 1.
- The procedure should be conducted as part of an interdisciplinary approach, including proper wound care, treatment of any co-morbid medical conditions, and appropriate revascularization (when needed) 1.
Surgical Approach
- The approach to the surgery should be based on the anatomy of the foot and the ways in which infection spreads through its fascial planes 1.
- The aim of surgical treatment is to drain any deep pus and to minimize tissue necrosis by decompressing foot compartments and removing devitalized and infected tissue 1.
- A specimen of bone should be obtained at the time of surgery for analysis by culture and histopathology 1.
From the Research
Transmetatarsal Amputation Surgery Time
- The average time for a transmetatarsal amputation surgery is not explicitly stated in the provided studies 2, 3, 4, 5, 6.
Healing Time
- The median time to primary healing after transmetatarsal amputation was 31 days (range 16-253 days) 2.
- The average time until further proximal amputation after TMA was 3.5 months 3.
Surgery Outcomes
- Primary closure of transmetatarsal amputation resulted in a significantly greater overall healing rate of 78.8% compared to open transmetatarsal amputations, with a healing rate of 37.9% (P < .01) 6.
- Closed transmetatarsal amputations were statistically significantly less likely than open transmetatarsal amputations to have recurrent gangrene, require revision pedal operations, or progress to higher level amputations 6.