Proximal Midfoot Amputation as a Functional Alternative to Major Amputation in Advanced Diabetic Foot Infection: A Case Report.
For people with advanced diabetic foot infections, doctors sometimes have to amputate part of the foot to save the patient's life. This case report describes a middle-aged man with a severe diabetic foot infection that had spread deep into the foot. Rather than amputating below the knee, surgeons performed a proximal midfoot amputation, removing only the front part of the foot while preserving the heel and ankle. This approach allowed the patient to keep his own leg and later walk using a specially fitted prosthesis. The report details the surgical steps and the patient's recovery over several months. The key finding is that this less extensive amputation can be a functional alternative to major amputation in selected cases. It offers a chance to maintain mobility and independence without losing the entire lower leg. However, because this is a single case report, the results may not apply to everyone; more research is needed to confirm when this technique works best.
Key takeaways
- A proximal midfoot amputation removes only the front of the foot, preserving the heel and ankle for better balance and walking.
- This case shows a patient with severe diabetic foot infection avoided below-knee amputation and walked again with a prosthesis.
- Doctors must carefully select patients based on infection extent, blood flow, and overall health for this surgery to succeed.
- Keeping the heel allows for a more natural gait and less energy to walk compared to a below-knee amputation.
- Ask your doctor if a partial foot amputation is possible instead of a major amputation, and what the risks and benefits are.
- This is a single case report, so it does not prove the technique is better for everyone; discuss all options with your care team.
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This content summarizes published medical research for educational purposes only. It does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making treatment decisions.
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Editor's note
Think of your foot like a house: when infection destroys the front rooms, you can sometimes seal off that part and still live comfortably in the back rooms, rather than tearing down the whole house. That's what a proximal midfoot amputation does—it removes only the infected front of the foot while keeping the sturdy heel and ankle, which are essential for standing and walking. If you've been told your wound won't heal or that amputation is the only option, this research offers a middle path: you might keep your leg and walk again with a well-fitted prosthesis. In China's specialist DFU centres, this type of limb-sparing surgery is performed, though not every patient is a candidate—it depends on how much infection is present and whether blood flow can be restored. For an overseas patient, that means it's worth asking about partial foot amputation before agreeing to a below-knee amputation.