Transmetatarsal amputations (TMA) is the surgical removal of part of the foot that contains the metatarsals. The five bones that are located between the ankles of the foot and the toes are called metatarsals.TMA is a fairly common operation to treat infected or severely ill feet. When all other surgical options for saving the foot or limb fail, surgeons will resort to TMA surgery. It is possible to save the limb by removing the infected portion.
Is transmetatarsal Amputation necessary?
Transmetatarsal amputation (TMA) is necessary to stop any further loss of tissue in the foot.
Forefoot gangrene, a lack of blood flow-induced tissue death.
Combination of two or more above can be complicated by diabetes.
A major accident left forefoot severely crushed.
How is transmetatarsal amputation performed?
Before you have your surgery
The patient will need to be admitted at night before surgery.
As directed by the doctor, you can take necessary medicines with very little water.
During Surgery
To keep the patient awake and free from pain while they are asleep, the surgeon may give general anesthesia. To numb the surgical area, the surgeon may give the patient spinal anesthesia.
First, the surgeon will incision ( cuts ) the forefoot of the patient.
The surgeon will remove infected and damaged bones.
Next, the surgeon will remove all nerves and blood vessels as well as tendons.
If the infection is very severe, the surgeon will wrap the surgical wound in sterile bandages. The wound can be closed with staples or sutures.
A surgeon may use skin grafts from donors or other parts of the patient to cover the wound.
The surgeon may need to trim the wound or attach it to drains in order to remove excess blood and fluid.
The surgeon will use sterile water to clean the wound and then apply a wrap.
After Surgery
The patient will then be moved to the general ward where they will remain for several hours.
Analgesics, as well as antibiotics, will also be given. To continue with Intranavenous fluids (IV).
The bandage will be taken off usually by the third day. The healing of the wounds will be checked and the wound to be cleaned and bandaged again.
After a hospital stay lasting between 5–14 days, the patient is discharged.
What are the complications associated with transmetatarsal amputation?
Transmetatarsal anamputation (TMA), is a highly-complicated surgery that can lead to complications like the following:
Further amputation is required: Infection of structures nearby to the wound can further damage the limb and may require amputation.
Wound infection: Diabetes increases the risk of getting a wound infected.
Delayed healing: it may occur if there are co-existing conditions like diabetes mellitus or ischemic cardiac disease, hypertension, chronic kidney disease, and hypertension.
Nonhealing wound
Heterotopic osteotomy: This describes an abnormal growth in bone tissue, including muscle and tendons.
Joint contracture: refers to restricted movement of the closest joint to the part that has been amputated.
Phantom sensation pain: This is a feeling that the amputated area is still present, and it’s very painful.
Blood clot in the leg.
A blood clot within the lungs.
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