Toe amputation is the surgical removal of all or part of one of a toe. Gangrene, frostbite, and atherosclerosis are the most common conditions which might require toe amputation. Amputation surgery on the toe is fairly simple, usually requires little time in the hospital and, once healed, leaves the patient with few side effects or walking disabilities.
Gangrene occurs when tissue dies due to infection or a lack of blood flow to an area, and is a common occurrence in extremities such as fingers and toes. Severe, and often poorly treated, injuries such as burns or severe trauma resulting in crushed bone and broken skin are common causes of gangrene. Inadequately attended circulatory diseases such as diabetes and arteriosclerosis can also cause gangrene. When gangrene occurs, it is essential to treat it immediately to prevent more tissue from dying and any spread of infection. In extremities such as the toe, the treatment is typically amputation followed by an aggressive course of antibiotics.
Frostbite, or tissue death due to cold exposure, can sometimes lead to toe amputation. When the body is exposed to extreme cold for a long period of time, it sacrifices the extremities to save the vital organs. This is done by constricting the blood vessels in the arms and legs, reserving blood for the vital organs instead and keeping the core body warmer. The lack of blood circulation in the extremities deprives the tissue of oxygen and nutrients, and causes cell death. Toes and other distal extremities are the body parts most often affected by frostbite, and may require amputation.
Atherosclerosis is a vascular disease where the walls of the arteries thicken, reducing the circulation of blood. Extremities are often the first parts of the body to experience the severe effects of long-term and poorly treated atherosclerosis. In the toes, tissue death sets in after prolonged starvation of blood. Diabetes, smoking, and hypertension increase the risks of atherosclerosis.
Toe amputation is fairly simple surgery, lasting only about one hour. Just before surgery, the patient is given intravenous antibiotics, general anesthesia, and the foot is thoroughly cleaned and disinfected. The skin at the base of the toe is opened, and the blood vessels are closed off. Bones and muscles in the toe are then removed, and the skin is stitched closed. If the area is severely infected, a drain may be put in place to prevent the spread of infection, or the area may be left open and packed with special wound dressings which can be changed and monitored.
The hospital stay following toe amputation is usually from one to seven days, depending on the presence and degree of infection. Following surgery, the patient will receive physical therapy to learn to balance without the amputated toe while walking and running. A special shoe may be needed for a few weeks as the wound heals.