Postgraduate Orthopaedic Theory Answer

DNB Ortho April 2023 - Paper I

Question:

a) Describe briefly various types of foot & ankle amputations. [6]

b) Describe features and use of SACH foot. [4]

Answer:

a) Various Types of Foot and Ankle Amputations [6]

Foot and ankle amputations are performed to remove diseased or nonviable tissue while preserving as much limb length and function as possible. The common types are described below:

Amputation Type	Level / Description	Indications	Key Features
Toe Amputation	Removal of one or more toes	Localized infection, trauma, gangrene	Preserves foot length; minor impact on gait
Ray Amputation	Amputation of toe with corresponding metatarsal	Severe infection, tumor, or trauma limited to ray	Preserves foot width and function better than transmetatarsal
Transmetatarsal Amputation	Through the metatarsal shafts	Extensive forefoot infection or ischemia	Maintains weight bearing heel; requires good vascularity
Midtarsal (Chopart) Amputation	Through talonavicular and calcaneocuboid joints	Severe forefoot trauma or infection	Preserves hindfoot; high risk of equinus deformity
Lisfranc Amputation	Through tarsometatarsal joints	Severe forefoot injuries with midfoot involvement	Preserves some foot length; potential instability
Syme Amputation	Through ankle joint with removal of foot but preserving heel pad	Severe distal foot trauma or infection with good vascularity	Weight-bearing stump…