Losing part of your foot or some of your toes does not mean you have lost the ability to live your life to the fullest. You have the benefit of learning from the countless others who have gone through both trauma and recovery.
Having partial-foot or toe amputation is common in the United States. Every year 73,000 Americans will lose part of a lower limb due to the complications of diabetic neuropathy. Thousands more lose toes or part of their feet as a result of accidents in the workplace or at home.
This guide is an entry point to understanding what you can expect as a new partial-foot or toe amputee and where to find additional resources.
Amputation Considerations and Quality of Life
When the patient and surgeon plan a partial-foot amputation, the surgeon will determine how much of the foot should be removed. The surgeon decides how much of the foot will be removed depends on factors such as:
- How much of the bone can he or she preserve while still providing a cushion for prosthetics;
- How will the remaining muscle, skin, and nerves affect the quality of life; and
- Preserving balance and gait when walking.
Rather than try to save as much of the foot bone as possible, the surgeon may decide that more may be removed if it will ultimately result in better balance or more comfortable prosthetic options.
Recovery and Rehabilitation
Following surgery, a prosthesist will fit you with a rigid dressing or cast, and you will have regular appointments with your doctor to change the dressings and check your healing. The remaining foot may be swollen for more than a month after surgery. You will also be prescribed medications for pain and to fight infection.
It is vital to follow your doctor’s advice related to your bandages and care of the surgery area. Do not remove the bandages yourself, shower or soak your foot until you the doctor says that it is okay.
You will begin a rehabilitation program when the wound has healed. Rehab is designed to help you adjust to a prosthesis and learn to get around when not wearing one. Depending on your injury you may end up doing a lot of the rehabilitation work independently at home.
Generally, you will start with a temporary prosthesis, and be fitted for a permanent prosthetic when the residual limb heals, usually within 6-12 months. You will have to work your way back up to walking without support, starting with short walks and increasing the distance each day.
You will soon be able to resume normal daily activities such as walking and driving and wear conventional shoes with your prosthetic. You can even ride a bike. However, you may need to consider modified versions of some other athletic activities which you can discuss with your doctor.
Partial-Foot Prosthetics and Shoes
Partial-foot prosthetics and shoes are custom-made to fit your residual foot and provide you with the support lost from amputation.
Shoe Inserts or Custom Shoes
A partial-foot insert is a rigid footplate for a standard shoe with raised areas to fill in space where your amputation is. Similarly, you can have custom shoes made to provide the same function and additional support for your balance and gait.
Custom-molded Foot Prosthesis
A silicone prosthesis can be designed to replace the missing area of your foot. Silicone can be painted to resemble your natural foot and toes. These prostheses include contoured arch supports and carbon fiber keels to provide weight bearing and a natural gait.
Toes’ Effect on Balance
Your toes provide balance and support when walking, and remain on the ground 75% of the time when doing so. Losing one or more toes can affect your balance depending on the toe(s) lost.
Your big toe bears the brunt of the weight when walking so losing it will result in more dramatic balance issues. Losing any of the three middle toes can also affect your balance, but the loss of a pinky toe does not effect on balance at all.
Recovery and Rehabilitation
Pain will typically improve after a week after surgery, with any stitches or sutures removed 10 days after. Swelling in the area could remain for a month or so. You may need to wear a cast or special shoes for 2-4 weeks.
It is crucial to follow your doctor’s advice related to your bandages and care of the surgery area. Do not remove the bandages yourself, shower or soak your foot until the doctor has given you the okay.
As you begin to walk again, you may notice your balance is affected. Your balance will improve as you readjust. Try walking longer than you did the day before. Walking regularly and propping the affected foot up when sitting or lying down will help reduce swelling as you recover.
If your balance remains an issue after rehabilitation or you want a cosmetic replacement for your toe(s), prosthetics are available.
Silicone toes can be made to match your natural toes including your big toe and can be made as rigid as required to give you additional support and balance while walking. If any residual toe remains, it will attach directly to it, but if the toe removal is complete, then it will be wrapped around an adjacent toe.
For personalized support relating to your partial-foot or toe amputation, reach out to us at the Amputee Coalition. Our services and resources are free, and we aim to help those who have undergone amputation to recover and live their lives to the fullest.