Results of minor foot amputations for ischemia of the lower extremity in diabetics and nondiabetics.

Results of 208 minor amputations were analyzed in 179 patients who had no food pulses. Wound healing was assessed at 3 months in relation to diabetes and previous vascular surgery. The results suggest that simple removal of the toe or toes is not advisable unless the blood supply to the foot can be improved by vascular reconstruction or sympathectomy, or both. Transmetatarsal amputation should be considered more often as a conservative amputation for gangrene of the toes. The absence of a palpable posterior tibial pulse is a contraindication to the Syme's amputation.