Lisfranc Amputation for Extensive Forefoot Ischemic Gangrene

A patient with diabetes presented with extensive ischemic gangrene involving multiple toes and the forefoot, making local toe amputations insufficient for complete removal of non-viable tissue. Limb preservation required a more proximal but function-preserving approach.

A Lisfranc amputation was performed, removing all toes and metatarsals while preserving the tarsal bones and hindfoot. The wound was closed primarily with sutures. Minor superficial wound-healing complications at the incision line resolved with local wound care over the following 6 weeks. After healing, the patient was fitted with a custom prosthetic filler integrated into a therapeutic shoe, restoring forefoot length and improving gait.