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Partial foot amputations may not always be worth the risk of complications

Peter A Lazzarini, Matthew Malone and Paul R Wraight
Med J Aust 2014; 200 (11): . || doi: 10.5694/mja14.00476
Published online: 16 June 2014

To the Editor: Dillon and colleagues present a challenging perspective on the evidence comparing partial foot amputation (PFA) and below-knee amputation (BKA) outcomes.1,2 Australia's diabetes-related major amputation rates have only recently reduced to international levels3 and we fear that any oversimplistic perspectives may be detrimental to these improved rates and, importantly, to our patients. Thus, we believe these articles1,2 should be read cognisant of some important points.


  • 1 School of Clinical Sciences, Queensland University of Technology, Brisbane, QLD.
  • 2 Allied Health Research Collaborative, Metro North Hospital and Health Service, Brisbane, QLD.
  • 3 High Risk Foot Service, Liverpool Hospital, Sydney, NSW.
  • 4 Diabetic Foot Unit, Royal Melbourne Hospital, Melbourne, VIC.



Competing interests:

No relevant disclosures.

  • 1. Dillon MP, Fatone S, Morris ME. Partial foot amputation may not always be worth the risk of complications. Med J Aust 2014; 200: 252-253. <MJA full text>
  • 2. Dillon MP, Fatone S. Deliberations about the functional benefits and complications of partial foot amputation: do we pay heed to the purported benefits at the expense of minimizing complications? Arch Phys Med Rehabil 2013; 94: 1429-1435.
  • 3. Organisation for Economic Co-operation and Development (OECD). Health Care Quality Indicators: Primary Care: Diabetes lower extremity amputation. France, OECD 2013. http://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT (accessed Mar 2014).
  • 4. Dillon MP, Kohler F, Peeva V. Incidence of lower limb amputation in Australian hospitals from 2000 to 2010. Prosthet Orthot Int 2014; 38: 122-132.
  • 5. Izumi Y, Satterfield K, Lee S, Harkless LB. Risk of reamputation in diabetic patients stratified by limb and level of amputation: a 10-year observation. Diabetes Care 2006; 29: 566-570.
  • 6. Kanade RV, van Deursen RW, Harding K, Price P. Walking performance in people with diabetic neuropathy: benefits and threats. Diabetologia 2006, 49: 1747-1754.

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