Amputation toe
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In addition to the common indications for any amputation (e.g., infection, arteriosclerosis with gangrene, etc.), specific indications for toe amputations exist as well. For example, the fifth toe (the most commonly amputated toe) is usually removed for being overriding on the fourth toe. This toe can be amputated with impunity and this is usually preferred over reconstructive procedures because it is easy and definitive. Complications of toe amputations with regards to gait are minimal. For example, any single toe can be removed with little gait or stance disturbance. This is true for amputation of the great toe during standing or walking at a normal pace. However, if the patient walks rapidly a limp appears from the loss of the normal push-off provided by the great toe. With amputations of all toes, the patients gait is likewise normal with slow, but impaired with rapid locomotion. Additional complications specific to the toes include a severe hallux valgus deformity seen in amputations of the second (see below).
Diagnostic Images
Osteomyelitis
The below images show both the pre-operative and post-operative left foot of the same patient. The pre-op film demonstrate osteomyelitis of the distal first phalanx that was treated with a great toe amputation. (Courtesy of A. Gentili MD)
 Before amputation |
 After amputation |
Hallux Valgus
 Second toe amputation with resultant hallux valgus deformity. This is a common complication of second toe amputations and occurs because the great toe tends to drift toward the third to fill the gap left by the amputation. (Courtesy of A. Gentili MD) |
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Acknowledgments
This page is first contributed by Michael Harpur Edwards MD.
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
