The natural history of great toe amputations

Doug P. Murdoch, David G. Armstrong, Joel B. Dacus, Terese J. Laughlin, C. Brent Morgan, Lawrence A. Lavery

Research output: Contribution to journalArticlepeer-review

124 Scopus citations


The purpose of this study is to report the prevalence of reamputation following resection of the great toe and first ray in adults with diabetes. We abstracted the medical records of 90 diabetic great-toe and first-ray amputees admitted between 1981 and 1991. The most common etiologies of initial amputations were ulcer with soft tissue infection (39%), ulcer with osteomyelitis (32%), and puncture wounds (12%). Sixty percent of all patients had a second amputation, 21% had a third, and 7% had a fourth. Fifteen percent of the patients who had a second amputation had it contralaterally. Seventeen percent subsequently underwent a below-knee amputation and 11% had a Transmetatarsal amputation on the same extremity, 3% had a below-knee amputation, and 2% a transmetatarsal amputation contralaterally. The mean time from the first to the second amputation was approximately 10 months. The results of this study suggest that a large proportion of patients undergoing an amputation at the level of the great toe or first ray have subsequent amputations in the first year following the initial procedure. Additionally, it appears that the contralateral foot may be at significant risk for distal amputation following resection of the hallux or first ray.

Original languageEnglish (US)
Pages (from-to)204-208
Number of pages5
JournalJournal of Foot and Ankle Surgery
Issue number3
StatePublished - 1997
Externally publishedYes


  • Amputation
  • Diabetes
  • Great toe
  • Hallux

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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