Houston Methodist. Leading Medicine

Foot FAQ

Question:

My father just came back from the doctor's convinced he needs his big toe amputated. He has diabetes and a host of other problems but this seems pretty drastic. Aren't there other ways to treat this without cutting the toe off?

Answer:

Wounds that fail to heal in the feet of patients with diabetes are a serious problem. Treatment begins with prevention. Daily inspection of the feet is essential. When even the smallest problem shows up, patients are advised to contact their doctor or other health care provider.

Quick and early intervention can sometimes make the difference between saving and losing toes and limbs. But even early and appropriate wound care can fail. Patients who smoke are more likely to experience delayed wound healing.

Those individuals who have loss of sensation called diabetic neuropathy are also at increased risk of wounds that don't heal. The patient may not feel the sore until it has become infected or deep. Treatment takes much longer in these cases. A positive result can also be prevented by the presence of poor circulation, a common problem in this patient population.

Amputation is suggested for one of the following five reasons:

  • severe loss of blood supply
  • uncontrolled infection
  • loss of function from structural changes
  • other diseases preventing healing
  • extreme pain

    Believe it or not, sometimes losing a toe can save a foot. Chances for healing are greater in some patients if an infected toe is removed before the whole foot is affected. Losing a smaller part of the limb may help preserve function of the larger body part.

    You are right to be concerned. Ask your father for permission to contact the doctor. It may help you plan appropriately if you know all the circumstances of the case, and why this decision has been made. It's also possible that with more family support, there are other options that can be considered before amputation. Michael B. Strauss, MD, and Stuart S. Miller, MD. Diabetic Foot Skin and Toenail Care: Debunking the Myths. In The Journal of Musculoskeletal Medicine. August 2007. Vol. 24. No. 8. Pp. 348-351.

    *Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
    All content provided by eORTHOPOD® is a registered trademark of Medical Multimedia Group, L.L.C.. Content is the sole property of Medical Multimedia Group, LLC and used herein by permission.
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