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.
The full article is accessible to AMA members and paid subscribers. Login to read more or purchase a subscription now.
Please note: institutional and Research4Life access to the MJA is now provided through Wiley Online Library.
- 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.
No relevant disclosures.