New and Recurrent Ulcerations after Percutaneous Achilles Tendon Lengthening in Transmetatarsal Amputation

Javier La Fontaine, Damieon Brown, Moffatt Adams, Michael VanPelt

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

The purpose of the study was to review the incidence rate of new and recurrent ulcerations in transmetatarsal amputations after original ulcers healed with percutaneous Achilles' tendon lengthening as an isolated procedure. We reviewed 35 charts from period of January 1995 to March 2007, and 28 were included for the final review. Twenty-four ulcers were grade 1A, 2 were 0A and 1B, and 1 was 1C using the University of Texas Grading System. Time to heal of ulceration post-TAL was 9.4 weeks (range 3-72 weeks). For statistical analysis, we used binomial distribution for dichotomous variables. Results demonstrated 4 limbs did not heal, 10 patients had an ulcer recurrence (p<0.001), and 6 developed new ulcers. Of the 28 patients in which TAL was performed, 16 developed new neuropathic ulcers (including recurrent ulcers; p=0.0099). High recurrence and new ulcers formation exist after TAL in patients with an unbalanced metatarsal amputation, and extrinsic/ intrinsic factors may need to be addressed to prevent recurrence. Level of Clinical Evidence: 4.

Original languageEnglish (US)
Pages (from-to)225-229
Number of pages5
JournalJournal of Foot and Ankle Surgery
Volume47
Issue number3
DOIs
StatePublished - May 1 2008

Keywords

  • equinus
  • tendo-achilles lengthening
  • transmetatarsal amputation
  • ulcer

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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