A Guide To Orthotic And Prosthetic Options For People With Partial Foot Amputations
Partial foot amputation is the most commonly performed amputation — affecting approximately two in every 1,000 people — and complications such as ulceration and re-amputation are all too common sequelae in these challenging patients. There is little consensus regarding the appropriate post-partial foot amputation modalities. Following partial foot amputation, clinicians must attempt to maintain function and reduce force loading along the residual foot stump in order to reduce further skin breakdown and subsequent secondary limb loss in these challenging patients.
While there is a paucity of evidence-based medicine regarding the use of prosthetic interventions, there is increasing research into these topics. Much of the current literature suggests that the above ankle prosthetic interventions that eliminate ankle motion improve ankle power generation during the gait cycle and reduce overall strain on the patient’s cardiovascular system while also reducing potential shear forces along the residual stump, thus reducing risk of re-ulceration.8,15-18
While further research is necessary, the clinician will always need to weigh various considerations including level of amputation and realistic functional expectations when prescribing a specific type of orthosis or prosthetic device following partial foot amputation to maintain the highest level of function.
Dr. Fitzgerald is an Assistant Professor of Surgery at the University of South Carolina School of Medicine-Greenville in Greenville, S.C. He is also affiliated with the Center for Amputation Prevention with the Greenville Health System in Greenville, S.C. Dr. Fitzgerald is a Fellow of the American College of Foot and Ankle Surgeons.