Due to his deconditioning and multiple complex diagnoses, the patient was discharged to a long-term assisted-care facility. Two weeks later, the transmetatarsal amputation site became necrotic, and the patient underwent below-the-knee amputation. The patient did not undergo angiography at any time before his amputations. Upon presentation to Metro Health Hospital, the patient’s medical history was significant for type II diabetes, hypertension, congestive heart failure, dyslipidemia, acute renal insufficiency, and peripheral vascular disease. The patient initially presented to the wound clinic for evaluation of a small, nonhealing ulcer on his left stump. The patient reported intermittent wounds over the course of 6 years due to rubbing of his prosthesis. In addition to the ulcer on the patient’s left stump, he reported a 1-week history of rest pain in his right toes and diffuse erythema of the anterior aspect of his right lower extremity. The erythema was deemed unlikely to be ischemic in nature. An x-ray was performed, revealing gas in the soft tissues, which is suggestive of cellulitis or ulceration. No radiographic evidence of osteomyelitis was noted. The patient began undergoing serial debridement therapy with ongoing wound assessment.
Transmetatarsal Partial Foot Slipper-Type Prosthesis is designed to permit better distribution of forces on the patient’s residual foot and more emphasis on cosmesis and less on functional ambulation for the transmetatarsal amputee.
ambulation, amputation, gait, prosthesis, prosthetic fitting, rehabilitation, satisfaction, transfemoral amputation, transmetatarsal amputation, transtibial amputation.