Toe Amputation: Causes and Consequences

Q: What are the most common reasons for toe amputation?  

A:  Toes may need to be amputated for a variety of reasons.  One of the most common reasons is infection.  A toe may be removed to prevent an infection from spreading to the bone or bloodstream, or because it is gangrenous. (Gangrene is a condition where the tissue dies after blood supply has been cut off to an area.  In situations where the tissue is infected, gangrene is classified as wet or moist gangrene.)  Infections in the toes are especially dangerous for people living with diabetes or lymphedema whose poor vascular and lymphatic health make it difficult to fight off the infections even in the most minor of foot injuries.  

People with foot deformities such as hammertoe and claw toe are also more likely to run into problems with infection due to the fact that their misshapen toes are vulnerable to injuries from footwear that fails to properly accommodate the deformity.  In addition to infection, toe amputation may be necessary due to trauma to the toes.  A severe burn, frostbite or a crush injury all may require amputation.  Finally, sometimes toe amputations are necessary for reasons unique to the toes.  For example, the fifth toe may be amputated if it constantly overrides the fourth toe.  Or the big toe may be amputated in the case of a toe deformity known as hallux valgus.  

Q: What are the consequences of toe amputation?

A: Most people can lose several of their toes and still have no problem walking.  Even if the big toe is amputated balance and gaits should be only marginally affected when the amputee is walking at a leisurely pace.  However, a limp may arise when the amputee attempts to pick up the pace.  This is because the amputee no longer is able to use the big toe to “push off” from the ground.  The same is true for an amputee who has lost all five toes.  When walking slowly or standing still, balance is maintained.  But any attempt to move faster will result in a limp or other balance issues.

Reoccurring infection is another long-term consequence of toe amputation.  Foot ulcers tend to reform over the same area.  The skin covering the residual part of the limb should be checked regularly for irritation, fissures or lesions.  Footwear should be fitted by a doctor to ensure that it will not chafe the skin, and that it will help the amputee to maintain his balance.