Partial foot amputations are often also considered as prostheses. They can be categorized as Prostheses because they carry elements of prosthetic challenges as well as orthotic challenges. There are three ways to treat a partial foot, patient. If the clinical team has to choose among three options, a clinic team must duly consider the entire alternative and choose according the need of a patient.
French surgeons Jacques Lisfranc (1790-1847) credited with developing the ankle-sparing hindfoot and midfoot amputations. The technique was developed to treat a forefoot gangrene that was designed to disarticulate the forefoot from the midfoot. Later, it was in the effort to cure the disturbing hazardousness of the metatarsal amputation that led to the development of chop art amputation. Francois Chopart developed the amputation that got named after him, which was usually performed to prevent the spread of forefoot gangrene. His apprentice, Lafitteau, elaborated the procedural aspects while writing in a 1792 article. Amputating through the hindfoot-midfoot junction downsized the number of post-operative deaths occurring due to infection by 50 percent in that pre-antisepsis era, as compared with amputating through the forefoot bones.
From a biomechanical standpoint, these amputations are similar. Although it seems intuitively desirable to preserve active ankle motion, this has proven to be of only limited practical value due to the short bony lever arm remaining. Because of this “leverage deficiency,” it is impossible for these patients to push actively off and raise their center of mass. Even with the best available prosthetic restoration, the residual limb cannot tolerate the forces necessary for active push off, although an artificial limb may restore some measure of passive rollover.
The difference between three types of partial foot amputees could be categorized on a spectrum on the basis of their biomechanical efficiency. Biomechanical aspects includes various factors such as protection being provided to residual limb, the weight bearing forces being left upon remaining skin, loading on the foot remnant, the comfort for the patient, appearance and the stride, activities they wish to perform. The different types range from elephant boot, the custom made “short shoe” to a high top shoe. In prosthesis a supermalleor is a silicon device that can be used to achieve a soft forefoot. However, all the discussed devices have their limitations.
All these different types of amputees have been conclusive in changing the lives of people. Their development is a result of expertise and crucial challenges of history’s co-existence. Now the focus is on maintaining the legacy and innovation to further simplify lives. The contribution buy Jacques Lisfranc and Francois chopart tells us that the adverse conditions such as war has given new ideas and purposive outcomes. Hence, it is important for us as human beings to continuously work toward delivering for larger human goal of serving humankind. Making life and struggle of of those who are most vulnerable less critical and joy has encouraged the instinct of fraternity in us always. The institutions, developers and trainer of amputees show us that uncertain mishaps has not made lives of human less productive in any way.
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