Lisfranc Amputation for Extensive Metatarsal Osteomyelitis

Clinical presentation, surgical treatment and documented healing.

01 / Problem: Clinical presentation
02 / Procedure: Surgical approach
03 / Outcome: Healing & follow-up

Clinical photographs below include wounds and surgical treatment.

01 / CLINICAL PRESENTATION

Problem

A 67-year-old patient with type 2 diabetes presented with osteomyelitis involving the second, third, and fourth metatarsals. Rather than performing multiple segmental metatarsal resections, a more functional limb-salvage strategy was selected to preserve foot stability and provide a durable weight-bearing surface.

Lisfranc Amputation for Extensive Metatarsal Osteomyelitis before image — Problem

02 / SURGICAL APPROACH

Procedure

A Lisfranc amputation was performed, removing the metatarsals and phalanges at the tarsometatarsal joint while preserving the tarsal bones. This approach created a balanced residual foot, offering better alignment and more stable contact with the ground than partial metatarsal resections.

03 / HEALING & FOLLOW-UP

Outcome

The wound healed successfully following primary closure, with only minor superficial wound-healing issues that resolved during follow-up. The patient was subsequently fitted with a custom prosthetic filler and specialized therapeutic footwear, restoring a stable, plantigrade foot and enabling safe ambulation. This case demonstrates that, in selected patients with extensive metatarsal osteomyelitis, a Lisfranc amputation may provide superior long-term function compared with multiple isolated metatarsal resections.