What is toe amputation?
Toe amputation is a common procedure performed by a wide variety of healthcare providers. One of the most common indications for toe amputation is patients with a diabetic foot. Most of these procedures are performed by a general or foot surgeon.
Toe amputation is usually performed as a last resort when medical treatment fails, or the toe cannot be salvaged. Systemic diseases such as diabetes and hypertension need to be managed, and they affect the blood vessels and nerves.
The method of toe amputation (disarticulation vs. osteotomy) and the level of amputation (partial or whole digit) depend on the extent of disease and anatomy. With any amputation, the degree of postoperative functional loss is usually expected and proportional to the amount of tissue amputated. The big toe is considered the most important of the toes in functional terms.
When is toe amputation done?
There are three broad indications for amputation of any body part:
- Dead loss
A “dead” toe is the one in which the blood supply is so completely compromised that infarction and necrosis (tissue death) develop with a nonviable tissue turning dry and black. A “dead” toe is most commonly observed as a complication of diabetes due to vascular disease. Other major risk factors for peripheral vascular disease are smoking, hypertension, hyperlipidemia, narrowing or spasm of blood vessels, or severe frostbite.
A “deadly” category results in systemic sequelae and can be deadly if not managed immediately. Malignancy may also require amputation, though infrequently.
A toe is a “dead loss” when it is diseased to the point where it is irreparable and is no longer functional.
When should toe amputation not be done?
The main contraindication for toe amputation is if the dead tissue is poorly demarcated and patchy. If the borders of the dead tissue area are unclear, the surgeon would not be able to demarcate the extent of the disease, affecting the results of surgery. Amputation of any body part is contraindicated if it results in a significant decrease in quality of life in case of a limited life expectancy.
How is toe amputation performed?
Prior to toe amputation, the surgeon performs a detailed clinical assessment and complete blood analysis. Moreover, they perform a thorough assessment of the status of nerves and blood vessels of both limbs.
- The procedure is performed under anesthesia and is relatively quick.
- The affected toe is completely amputated with a margin of normal, healthy tissue.
- The method of toe amputation (disarticulation vs osteotomy) and the extent of amputation (partial or whole digit) depend on the extent of disease and anatomy.
- The wound is left open. Dressing and wound cleaning are done regularly until the wound heals completely.
- The complete recovery period from the toe amputation surgery is two to four weeks.
What are the complications of toe amputation?
Some common complications encountered are as follows:
- Pain, swelling, and bruising
- Inadequate hemostasis (blood clotting), which causes bleeding
- Hematoma (blood clot)
- Inadequate amputation leading to spread of disease
- Failure to heal—this could be due to inadequate blood supply as well or due to ongoing infection
- Spread of infection to the rest of the body (tetanus)
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Diabetes (Type 1 and Type 2)Diabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Diabetes QuizTake the Diabetes Quiz and learn the causes, signs, symptoms, and types of this growing epidemic. What does diabetes have to do with obesity and diet? Learn about life as a diabetic.
Diabetes Symptoms in MenDiabetes mellitus is a disease in which a person's blood sugar (blood glucose) is either too high (hyperglycemia) or too low (hypoglycemia) due to problems with insulin regulation in the body. There are two main types of diabetes mellitus, type 1 and type 2. Type 1 diabetes usually occurs during childhood, while type 2 diabetes usually occurs during adulthood, however, rates of both types of diabetes in children, adolescents, and teens is increasing. More men than women have diabetes in the US, and the disease can affect men differently than women.
Warning symptoms of diabetes that men have and women do not include low testosterone (low-t), sexual problems, impotence (erectile dysfunction), decreased interest in sex, and retrograde ejaculation.
Type 1 and type 2 diabetes symptoms and signs that are the same in men and women include skin infections, numbness or tingling in the feet or hands, nausea, excessive thirst or hunger, fatigue, irritability, blurred vision, weight gain, weight loss, urinary tract infections (URIs), and kidney problems.
Treatment for type 1 diabetes is insulin, and treatment for type 2 diabetes are lifestyle changes like eating a healthy diet, getting exercise daily, and if necessary, diabetes medications.
Diabetes Symptoms in Women (Early and Late)Diabetes symptoms in women include vaginal itching, pain, or discharge, loss if interest or pain after having sex, polycystic ovarian syndrome (POS), and urinary tract infections or UTIs (which are more common in women.
Symptoms of diabetes that are the same in women and men are excessive thirst and hunger, bad breath, and skin infections, darkening of skin in areas of body creases (acanthosis nigricans), breath odor that is fruity, sweet, or acetone, and tingling or numbness in the hands or feet, blurred vision, fatigue, tingling or numbness in the hands or feet, wounds that heal slowly, irritability, and weight loss or gain.
Complications of type 1 and type 2 diabetes are the same, for example, skin, eye, and circulation problems, low blood sugar (hypoglycemia), high blood sugar (hyperglycemia), ketoacidosis, and amputation. If diabetes is not managed a person may not survive.
Diabetes Treatment: Medication, Diet, and Insulin
The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar. Type 1 diabetes is treated with:
- and a diabetic diet.
Type 2 diabetes is first treated with:
- weight reduction,
- a diabetic diet,
- and exercise.
When these measures fail to control the elevated blood sugar, oral medications are used. If oral medications are still insufficient, insulin medications are considered.
Type 2 Diabetes Diet PlanA type 2 diabetes diet or a type 2 diabetic diet is important for blood sugar (glucose) control in people with diabetes to prevent complications of diabetes. There are a variety of type 2 diabetes diet eating plans such as the Mediterranean diet, Paleo diet, ADA Diabetes Diet, and vegetarian diets.Learn about low and high glycemic index foods, what foods to eat, and what foods to avoid if you have type 2 diabetes.
Insulin Pump for DiabetesAn insulin pump is designed to deliver insulin directly to a patient with diabetes. They are about the size of a standard beeper. The pump is attached to under the skin (usually on the abdomen). The amount of insulin required will depend on lifestyle (exercise, sleep patterns, activity level, and diet).
Normal Blood Sugar Levels (Ranges) In Adults with Diabetes
People with diabetes can manage and prevent low or high blood sugar levels (hyperglycemia or hypoglycemia) by keeping a log of your blood sugar levels when you are eating and fasting and eat foods that are high in carbohydrates and sugar, for example, buttered potatoes, candy, sugary desserts, and fatty foods.
Blood tests, for example, the hemoglobin A1c test (A1c test) and urinalysis can diagnose the type of diabetes the person has. Diabetes during pregnancy, called gestational diabetes, should be managed by you and your OB/GYN or another healthcare professional.
Extremely high levels of blood glucose in the blood can be dangerous and life threatening if you have type 1, type 2, or gestational diabetes.
If you or someone that you are with has extremely high blood glucose levels, call 911 or go to your nearest Urgent Care or Emergency Department immediately.
To prevent and manage high blood glucose levels in people with diabetes keep a log of your blood sugar levels, eat foods that are high in carbohydrates sugar, for example, buttered potatoes, candy, sugary deserts, and fatty foods that you can share with your doctor and other healthcare professionals.
Diabetes: What Raises and Lowers Your Blood Sugar Level?Want to lower your blood sugar? Learn to better control your glucose levels by preventing blood sugar spikes and swings to avoid neuropathy and other diabetes complications. Find foods that lower blood sugar, and identify foods and activities that raise high blood sugar risks.
Type 1 DiabetesWhat is type 1 diabetes? Is there a cure for type 1 diabetes? Learn about type 1 diabetes symptoms, warning signs, causes, and treatments.
Type 1 Diabetes QuizWhat are the causes of type 1 diabetes? Take this quiz and challenge your knowledge of causes, symptoms, diagnosis and treatments for this common condition, formerly known as juvenile diabetes.
Type 1 vs Type 2 Diabetes (Similarities and Differences)
Diabetes mellitus is a metabolic condition in which a person's blood sugar (glucose) levels are too high. Over 29.1 million children and adults in the US have diabetes. Of that, 8.1 million people have diabetes and don't even know it. Type 1 diabetes (insulin-dependent, juvenile) is caused by a problem with insulin production by the pancreas. Type 2 diabetes (non-insulin dependent) is caused by:
Eating a lot of foods and drinking beverages with simple carbohydrates (pizza, white breads, pastas, cereals, pastries, etc.) and simple sugars (donuts, candy, etc.)
- Consuming too many products with artificial sweeteners (We found out that they are bad for us!)
- Lack of activity
While the signs and symptoms of both types of diabetes are the same, which include:
- Increased urination
- Increased hunger
- Increased thirst
- Unexplained weight loss.
However, the treatments are different. Type 1 diabetes is insulin dependent, which means a person with this type of diabetes requires treatment with insulin. People with type 2 diabetes require medication, lifestyle changes like eating a healthy diet, and getting regular exercise.
Type 2 Diabetes QuizWhat causes type 2 diabetes? Can it be prevented? Take this online quiz and challenge your knowledge of this common condition. Also, get the truth about myths and facts!
Type 2 Diabetes SlideshowLearn about type 2 diabetes warning signs, symptoms, diagnosis, and treatment options. Read how diet and exercise can help manage type 2 diabetes.
Diabetes Urine TestsUrine tests for individuals with diabetes is important to check for diabetes-related kidney disease and severe hypoglycemia. With proper monitoring of blood glucose levels, diabetic-kidney disease can be avoided.
What Is Transmetatarsal Amputation?Transmetatarsal amputation (TMA) involves surgical removal of a part of the foot that includes the metatarsals. TMA is a relatively common operation performed to treat a severely infected foot or a foot with lack of oxygen supply (ischemic). Surgeons resort to this type of surgery when all other nonsurgical options to save the foot or limb have failed. Removing the infected part prevents the infection from spreading to the other parts of the limb and thus saves the limb in the long run.