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Partial foot amputation may not always be worth the risk of complications

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Similarity in functional outcomes with partial foot and transtibial amputation focuses attention on complication rates

Partial foot amputation is increasingly common in Australia,1 and the rates of complications are disproportionately high compared with people who have transtibial (below-knee) amputation.2We draw attention to these recent observations in our publications, highlighting that contemporary beliefs about partial foot amputations do not always result in optimal outcomes, especially for older people.1,3

A lower limb amputation is performed in Australia nearly every hour. Of the 8000 lower limb amputations in Australia each year,1 many are the end result of the long-term complications of diabetes such as peripheral vascular disease, neuropathy and chronic non-healing ulceration of the foot.

There has been a considerable shift in the types of lower limb amputations performed in Australia over the past decade.1 The incidence of transfemoral and transtibial amputation has declined and the incidence of partial foot amputation has increased.1 In Australia three-quarters of all lower limb amputations are now at the partial foot level.1