Introduction: The effectiveness of the treatment has long been significant in diabetes and its
complications, especially in developing countries. Prolonged hospitalization and repeated surgery
should be avoided due to clinical and economic reasons. Wound breakdowns or necrosis can occur after
amputation procedures, and subsequently will require reamputation. This study analyzed susceptibility
factors in diabetic foot patients undergoing prior high toe amputation that are thought to be related to
Methods: We performed a retrospective analysis in 107 patients that have undergone amputation for
great toe gangrene, during May 2014-April 2019. Demographic data, clinical features, laboratory results
and treatment modality, were documented and statistically analyzed by simple and multiple logistic regression
Results: Of all 107 patients, 17 patients had to undergo early reamputation. Limited dorsiflexion, level
of amputation, and sepsis condition is shown to be significantly associated with first amputation. Multiple
logistic regression analysis confirmed a significant association of early reamputation with amputation
or disarticulation at the level of the metatarsophalangeal joint.
Conclusion: While limited ankle dorsiflexion and sepsis conditions need to be addressed comprehensively,
from the surgical options point of view, we suggest ray amputation to be preferred over metatarsophalangeal
joint disarticulation to prevent early reamputation.