Traumatic partial foot amputation.

Twenty patients in whom partial foot amputation had been performed following trauma were evaluated for successful retention of the foot. Of ten transverse stumps, only three partial feet were retained. Failure was related to poor terminal coverage from skin grafts and to equinus deformity. All ten longitudinal forefoot amputations resulted in salvage of the foot. In traumatic partial foot amputations only bone stock that is protected by innervated plantar skin should be preserved, and skin grafting should be done only in nonweight-bearing areas. Equinus deformity can be minimized by preserving and/or transplanting dorsiflexor tendons into residual bone and by supporting the foot in a custom-made ankle-foot orthosis.