Toe and forefoot amputation

Foot disease is where the tissues (skin and muscles) of your foot are dying.

Atherosclerosis happens when abnormal fatty material (atheroma) coats the inside of an artery, causing it to narrow or 'harden'. The amount of blood flowing through the artery is reduced

Surgery should relieve any pain, prevent the spread of infection, remove dead tissue, improve your mobility and can sometimes help you to return to normal activities.

Your foot is likely to become worse. The effects of infection or gangrene can spread into your body, causing you to become unwell.

Various anaesthetic techniques are possible.

The operation usually takes 15 minutes to an hour.

Your surgeon will remove any dead or infected tissue and will leave as much healthy tissue as possible.

Your surgeon may need to perform the amputation below your knee.

If you smoke, stop smoking now. Smoking is one of the main reasons why this problem happens. Stopping now can help to reduce the risk of you having a heart attack (where part of the heart muscle dies), having further narrowing of the arteries and developing certain cancers. Stopping several weeks or more before the operation may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

The healthcare team will try to reduce the risk of complications.

Any numbers which relate to risk are from studies of people who have had this operation. Your doctor may be able to tell you if the risk of a complication is higher or lower for you. Some risks are higher if you are older, obese, you are a smoker or have other health problems. These health problems include diabetes, heart disease or lung disease.

Some complications can be serious and may even cause death.

General complications of any operation

• Bleeding during or after the operation.
• Allergic reaction to the equipment, materials or medication.
• Blood clot in your leg (deep-vein thrombosis – DVT).
• Blood clot in your lung (pulmonary embolus), if a blood clot moves through your bloodstream to your lungs.
• Difficulty passing urine.
• Chest infection. Your risk will be lower if you have stopped smoking and you are free of Covid-19 (coronavirus) symptoms for at least 7 weeks before the operation.

Specific complications of this operation

• Damage to small blood vessels, which can cause a toe to die. You may need to have the toe removed (amputated).
• Amputation failure. If the tissue at the amputation site is unhealthy, your surgeon may decide, during the operation, to amputate below your knee.
• Infection of the surgical site (wound).
• Phantom limb sensation, where you can still feel the amputated part of your foot. Sometimes you can feel this sensation along with pain. Pain can be caused by continued infection, an amputation neuroma (a problem with a nerve end), a bone spur or scar tissue. These pains can continue for many months.
• Severe pain, stiffness and loss of use of your foot. Your foot can take months or years to improve.

Consequences of this procedure

• pain
• unsightly scarring of your skin

You will usually stay on the ward for up to 10 days so your wound can be checked.

The healthcare team will tell you when you can return to normal activities. You may not be able to go back home but will need to go into other accommodation appropriate to your physical abilities.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

You can expect to make a good recovery with a better quality of life.

Foot disease is a common condition caused by a poor blood supply to your foot. Removing any dead or infected tissue should prevent the spread of infection and improve your mobility.