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If you have diabetes with a bone infection in the toe, your doctor may suggest a toe amputation. However, toe amputations may also be needed if you have a severe hammertoe deformity with dislocation that causes chronic pain.
There are different kinds of toe amputations, including partial toe amputations, full toe amputations, and partial ray amputations.
If you are planning to undergo a toe amputation, it’s important to understand what to expect and how to care for the area afterward.
Toe Amputation Procedure- What to Expect
Toe amputations can be done in the outpatient setting under sedation anesthesia. The procedure will take 30 minutes-1 hour to complete. You will be sleeping during the procedure.
Partial Toe Amputation
Partial toe amputation is also known as “partial phalangectomy”. In this type of surgery, only a portion of the toe is removed.
There are three bones in every toe except for the great toe. In a partial amputation, your doctor will make an incision and remove a portion of the toe. The skin will be closed using sutures (thread). This procedure is done if you have an ulcer with a bone infection at the tip of the toe.
Full Toe Amputation
Full toe amputation is when the entire toe is disarticulated. Your doctor will make an incision at the base of the toe. The toe is removed at the metatarsophalangeal joint. This procedure is done if there is the presence of bone infection in one or more bones of the toes.
Occasionally, full-toe amputations may be performed if you have a painful toe that is severely deformed or dislocated.
Partial Ray Amputation
If you have a bone infection in the toe bones and the adjacent metatarsal head (knucklebone), your doctor may remove both the toe and the knuckle bone. This is called partial ray amputation.
Your doctor will make an incision at the metatarsophalangeal joint and remove the toe. They will then use a surgical saw to resect the metatarsal head and remove it. If there is an ulcer present at the bottom of the foot, it would be excised at the same time.
Toe Amputation Recovery- What To Expect
After the surgery has been completed, you will be able to go home the same day. However, it is important to keep your foot elevated after the surgery. This will reduce pain and swelling in the foot. Keep your foot elevated on two pillows.
Your doctor will prescribe pain medication to keep your pain under control.
The recovery process after toe amputation surgery will vary depending on which type of surgery you had and how many toes were affected.
If you underwent a single-toe amputation, you can remain partially weight-bearing in a post-op shoe for 4 weeks. Sutures will be removed at your doctor’s office two weeks after the surgery.
You will need to keep your dressing dry while in the shower. You can use a cast protector from Amazon to help keep the dressing dry. Full recovery after a toe amputation can take 4-6 weeks.
If you undergo multiple toe amputations or a partial ray amputation of the first metatarsal and great toe, your doctor will suggest you stay off of your foot in a cast boot for 4 weeks. This is because the great toe is important for balance. When the great toe is amputated, pressure should be removed from the area for a few weeks to help with the healing process.
Full recovery after a big toe amputation or first ray amputation can take 6-8 weeks.
Physical therapy may also be recommended to help you regain strength and mobility in your foot. Your doctor will recommend you go to physical therapy 3 times a week for 1 month.
Complications of Toe Amputations
Just like with any foot surgery, complications can occur.
Some of the complications you could experience after toe amputation surgery include:
- Infection: Like with any surgery, you can develop a skin infection after a toe amputation surgery. If you develop redness, warmth at the incision site, swelling, and pain, contact your doctor immediately. You may need antibiotics.
- Phantom pain: You may feel sharp, burning pain in the area where the toe was removed. This pain can last several months before it goes away. Your doctor will prescribe pain medication to help reduce the pain.
- Transfer lesions: If you undergo a toe amputation or partial ray amputation, your body adjusts the way you walk. This can cause transfer calluses to form in the adjacent parts of your feet. Offloading pads and inserts can help prevent transfer lesions.
- Gait Changes: Toe amputations can result in gait changes, as the body adjusts to the change in balance and weight distribution. This can lead to further pain and discomfort. Custom orthotics and appropriate shoes will be needed to help prevent pain. Talk to your foot doctor about obtaining a prescription for custom-made orthotics.
Can You Drive With an Amputated Toe?
You can drive with an amputated toe as long as your surgical site has healed (4-6 weeks after surgery). You should make sure to wear supportive shoes as well as custom inserts while driving. Avoid driving while taking narcotics, as this can be dangerous.
Is There a Prosthesis for Amputated Toes?
Depending on the extent of amputation, toe fillers may be needed. For instance, if you have a great toe amputation or partial 1st ray resection, foam fillers can be added to a custom shoe insole to help redistribute pressure away from the amputation site. Talk to your foot doctor for a prescription.
Toe amputations can be beneficial in alleviating both pain and infection. The goal of toe amputation is to improve the patient’s quality of life. It’s important to understand the risks of the surgery and communicate with your doctor regarding your expectations. With proper preparation and care, patients can generally make a full recovery and can return to their normal activities.
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