With the right support in place an amputation does not have to alter the quality of your life. If you understand the amputation process, how it might affect your life, and who you can look to for assistance, it can make all the difference to your future quality of life. Read on to find out more and to see what options are available to you.
What is foot amputation?
Did you know that the foot and ankle are made of up 26 individual bones and 33 joints? The foot itself is divided into three sections:
- Hindfoot: This contains the largest bone in the foot (the heel bone or calcaneus) and takes much of the weight that passes down through the ankle joint
- Midfoot: Forms the arch of the foot
- Forefoot: The five toes (phalanges) and five longer bones (metatarsals) behind them
In a foot amputation, one or more of these sections is removed, depending on which type of amputation is required. The different types of foot amputation are:
Syme’s amputation is when your foot is removed at the ankle. Essentially the whole foot is removed, but the lower leg is left intact. It is named after James Syme, who first published a paper in 1842 describing the procedure in patients who had suffered crushing injuries caused by trauma, non-healing ulcerations, neuroarthropathy and osteomyelitis. For more information, please read our article about Syme's amputation.
Chopart’s amputation is a partial foot amputation where the fore and midfoot are removed. The cut is made through your midtarsal joint – leaving the heel bone and ankle joint in place. As the heel is still there, you will be able to put weight on it as there is a good foot stump.
Lisfranc or transmetatarsal amputation is another form of partial foot amputation – but only the forefoot is removed. A cut is made across the metatarsal shafts to preserve the mid and hindfoot. This means:
you can still: stand and walk for short distances without needing orthotics or a prosthetic limb.
- the amputated foot can still fit into shoes and
- there is a better cosmetic outcome.
This form of partial foot amputation can be a common surgical option where there is poor blood flow in the foot or a severe infection following an injury or trauma.
Boyd procedure also takes place at the ankle level (like Syme’s amputation). The main difference however is that it retains the heel bone (calcaneus) and heel pad. As part of the heel bone is left and joined to the tibia, it can offer much more weight-bearing ability. This type of amputation is technically harder to perform than a Syme’s amputation.
Foot amputation: What are the causes?
An amputation may occur because of a traumatic injury or following surgical intervention.
Accidents are the most common cause of traumatic amputations and can involve the immediate separation of a foot or parts of it. The level of the amputation suffered in an accident may not be the final extent of the amputation. If the amputee suffers tissue damage this may lead to further removal by surgery. In some cases, the accident may not result in an immediate amputation. There may be an attempt to save the foot or toes, but if the injuries do not heal or are so extensive the part affected cannot be saved this may result in an early and sometimes lifesaving post-accident amputation.
The most common causes of a traumatic hand amputation include:
- an accident at work, usually involving machinery
- or a road traffic accident
- An accident involving defective household products.
A traumatic amputation can have serious consequences in the short term. It comes with the risk of shock, blood loss or infection. But rapid medical treatment can ensure it doesn’t end up being fatal.
Non traumatic causes of amputation include illnesses and medical conditions such as: diabetes; meningitis; compartment syndrome; delays in diagnosing vascular disease or cancer; post-operative blood clots; and infections.
Individuals who have been injured in accidents but initially do not require an amputation because there was hope the hand could be saved, may, as a last resort after many years of treatment and surgical interventions, opt for a voluntary amputation. This may be to relieve chronic pain, reduce the risk of infection or because nerve and ligaments damage has destroyed or severely impaired functionality.
For more information read our article about the common causes of amputation.
Foot amputation surgery: What does it involve?
If medical intervention is seen as the best or only course of action, full or partial foot amputation surgery is either done under general (where you are unconscious) or local anaesthetic. An epidural (which numbs the lower half of the body) or spinal anaesthetic might also be used – depending on the complexity of the surgery.
In the 1950s, Syme’s foot amputation surgery took place in two stages. Six to eight weeks after the removal, a second operation was needed to more firmly attach the fat pad of the heel to the stump of the tibia and fibula to create a platform on which to stand. Now, however, it is all done in one procedure with part of the lower end of the fibula and tibia being cut about half an inch from the distal ends. The fat and skin of the heel is then brought forward and attached to the stump.
How common is foot amputation?
It is still relatively rare for someone to suffer the loss of all or part of a foot – though this offers no comfort to those it does affect.
Data from NHS hospitals in England shows the foot amputation statistics for finished consultant episodes (FCE), which is a continuous period of admitted patient care under one consultant and within one healthcare provider. In the year 2021-22 toe amputations appear to be more common. There were 83 amputations of the foot at ankle level in comparison to 2209 amputations of the great toe. In total 10,066 amputations involving the foot occurred.
What is the impact of a foot amputation?
Our feet have such an important role to play in so much of what we do each day. To stand upright, it is your feet that are in contact with the ground. Together with your legs and ankles, feet also help us to move – walking, running or more extreme activities such as climbing.
The removal of all or part of a foot can have a significant impact on your day-to-day life for this very reason. It can mean changes to the way that carry out certain activities – and can also cause problems with your balance. The most important thing to know is that it is still possible to enjoy a high quality of life after foot amputation, but there will be a period of adjustment and rehabilitation. We partner with world-leading specialists in prosthetics, care, physiotherapy, rehabilitation and accommodation. This places us in a good position to help you during this period of adjustment by ensuring you are aware of the latest medical and technological advances so that you can make choices to improve aspects of your new life. We will also put you in touch with the right people so that we can build a support network tailored to your exact needs.
We can also provide guidance when it comes to deciding whether to engage the services of a Case Manager to help with care and assistance and to understand what you need in the way of aids and equipment and your entitlement to state benefits.
What are the risks of foot amputation?
You may, in the short-term, experience pain or bleeding after your operation. And there is also the chance of “phantom limb” – which is a unique condition where you still feel pain or sensation in the part of the foot that was removed.
You may also need to deal with:
- Ongoing emotional distress and feelings of loss
- Pain and soreness in the ‘stump’
- The possible need for revision surgery
We can put you in touch with experts and support groups to help you understand, prepare and overcome these risks – and longer-term concerns such as slow healing, infection or even conditions like deep vein thrombosis.
How can Shoosmiths help?
At Shoosmiths, we pride ourselves in going the extra mile to support people who are coming to terms with the often life-changing impact of a foot amputation. It can be especially tough when that impact is the result of a sudden and unexpected accident that is caused by someone else.
We can help you and your family rebuild your lives in a way that works for you – and overcome any challenges that you now face. Why not discover how we have helped others to get a better idea of how we can also help you?
By phoning us on 0808 301 7915 or sending us a message, you (or a loved one) can talk to us about your experience for free and in confidence. Use our legal expertise and knowledge to see whether you can make a claim for compensation – and how else we may be able to help you.
Our team of amputation claims specialists have many years of experience dealing with amputation claims. If your amputation was caused by either an accident that was not your fault, or the negligent treatment you received from a health professional, we can investigate your circumstances to establish whether you can make a claim for compensation. We can also assist with your rehabilitation and recovery. Any compensation you receive will help cover the cost of any care, ongoing treatment, lost income or even an arm replacement prosthetic.
Talk to us for free and in confidence. Call 0808 301 7915 today or send us a message.
This information is for educational purposes only and does not constitute legal advice. It is recommended that specific professional advice is sought before acting on any of the information given. © Shoosmiths LLP 2024