Stop Leaving the Pinky Toe: Why Incomplete TMA Amputations Fail
from Diabetic Foot Files Hosted by Diabetic Foot Files
Dr. G explains why leaving the fifth digit after other forefoot amputations creates biomechanical imbalance, increased lateral pressure, and recurrent ulcers. He reviews the muscle and tendon changes that drive varus/supination bias and lateral overload. The episode covers when a full transmetatarsal amputation (TMA) is preferable, the importance of adjunct procedures like Achilles tendon lengthening, and post-op management including orthotics, AFOs, rocker soles, and rehabilitation to restore balanced gait and prevent reulceration.
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Chapters
- 0:03 Introduction to Biomechanics
- 1:34 The Myth of Saving Digits
- 3:32 Biomechanical Disaster of the Fifth Toe
- 5:48 The Chaos of Leaving the Fifth Digit
- 6:39 Understanding Muscle Dynamics
- 11:37 Importance of Achilles Tendon
- 14:22 Benefits of Full Transmetatarsal Amputation
- 17:09 Post-Surgery Management Strategies
- 18:49 The Long-Term Approach to Rehabilitation
- 19:18 The True Meaning of Limb Salvage
- 23:23 Conclusion and Key Takeaways
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