# 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.

## Key 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.