INTRODUCTION
Diabetic neuropathy and the resulting partial foot amputation cause gait
alterations, including slower gait velocity, greater step variability,
greater inter-limb asymmetry, and altered ground reaction force
(GRF)1. These biomechanical alterations with impaired
walking capacity increase the risk of falls as well as musculoskeletal
comorbidities, including osteoarthritis in the contralateral
limb2, leading to loss of functional independence.
As partial foot amputation-induced gait alterations are prominent in
proximal amputation due, at least in part, to loss of moment
arm3, surgical techniques have been proposed to save
the foot and prolong the bipedal ambulatory function. However, the
currently available data regarding partial toe amputation patients are
limited. For example, patients who have undergone first ray amputation
display slower gait velocity, reduced step length, greater step
variability, and decreased hip extension4. To date, no
study has investigated the influence of non-first ray toe amputation on
gait alterations in patients with diabetic neuropathy.
Herein, we report the case of a patient who had undergone non-first ray
but multiple toe amputation, in who integrated gait analysis was
performed to assess spatiotemporal parameters, kinetics, and kinematics.
We demonstrated that multiple toe amputation caused a lack of push-off
with decreased hip extension in the ipsilateral limb accompanied by
elevated contralateral GRF. This single case study provides insight into
toe amputation-related biomechanical alterations and
serves as a framework for future
studies to establish an effective rehabilitative strategy and prevent
musculoskeletal comorbidities following amputation. The patient was
informed that data concerning the case would be submitted for
publication, and he consented to it.