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Figure 1 From A Modified Transmetatarsal Amputation Semantic Scholar Trauma, recurrent dupuytren contracture, and congenital abnormalities of the hand. indications, techniques, and outcomes vary based on the digit and the number of digits resected. compared with amputation at the proximal phalangeal level, a single ray resection has better cosmesis and similar function, resulting in improved patient satisfaction. however, a 15% to 30% loss in grip and pinch. Ray resection and reconstruction by either soft tissue coaptation (fig. 46.7) or ray transfer (fig. 46.8) closes this gap and improves the aesthetic appearance of the hand (22, 23). both procedures narrow the palm and thus predictably weaken grasp and cylindrical grip palmar stabilization. If more than two partial ray amputations are performed, regardless of location or distribution, progression to transmetatarsal amputation is preferred (fig. 33.12). this provides for a more even distribution of ground reaction forces on the plantar foot and a lessened potential for aberrant accommodation in the form of deleterious toe, foot, and or ankle contracture (fig. 33.13 ). Amputations are done urgently and electively to reduce pain, provide independence, and restore function. the goals of amputation are. preserve functional length. preservation of useful sensibility. prevention of symptomatic neuromas. prevention of adjacent joint contractures. early prosthetic fitting.
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