Pirogoff amputation is a viable option to maintain ambulation in chronic limb-threatening ischemia with extensive midfoot tissue loss: a report of two cases

TL;DR

Modified Pirogoff amputation helps preserve walking ability in patients with severe foot tissue loss due to chronic limb-threatening ischemia.

Contribution

Shows modified Pirogoff amputation as a viable treatment for CLTI with midfoot tissue loss when combined with revascularization.

Findings

Two patients with CLTI maintained ambulation without a prosthesis after modified Pirogoff amputation.

The procedure preserved functional outcomes in revascularized cases with extensive midfoot tissue loss.

Abstract

Eliminating necrotic and infected tissues is crucial for limb salvage in patients with chronic limb-threatening ischemia (CLTI). However, extensive lesions that involve the midfoot frequently result in transtibial amputation, restricting ambulation and independent life. The Modified Pirogoff amputation, which includes a 90° rotation of the calcaneus and fixation with the tibia, has good functional outcomes in trauma cases. Here, we report two patients with CLTI successfully managed by a combination of revascularization and modified Pirogoff amputation, resulting in preserved ambulation without a prosthesis. Modified Pirogoff amputation may be a viable option in revascularized CLTI with extensive tissue loss of the midfoot.

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