Techniques and results of midfoot amputation / 中华骨科杂志

ABSTRACT

Objective To summarize the techniques and results of midfoot amputation and discuss the role of the tendon balance in this operation.Methods Twenty-six traumatic midfoot amputions were performed from 1990 to 1999. The amputation level ranged from the base of metatarsal to the Lisfranc's joint. The bone stump should be smooth, round and arc featured, the amputation line needn't pass the joints, four extensor longus tendons were divided into two groups and the groups were weaved each other. Bone stump were drilled a hole through which extensor tendon stumps were re-attached to the bone stump. Anterior tibial tendon could also be re-attached to the front aspect of the bone stump with the above mentioned procedure. In case the navicular could not be preserved, midfoot amputation should be given up. Results Among the group, 15 cases were followed-up 2 to 10 years after operation. No case had equinovarus deformity, all cases could flex ankle dorsally to 0? or more, but 4 cases had painful callus on the stump, and 1 case slight ulceration. The other cases in the group got satisfactory outcomes. Conclusion In terms of midfoot amputation, different amputation level leads to different tendon imbalance. Proper tendon balance and appropriate stump repairing is of importance to reconstruct balanced plantar biomechanics,and then, to achieve good long term result.