Characteristics of the included studies
| Author | Country | Study design | Aim(s) | Sample size | Experimental group | Control group | Age in years (mean±SD) | Gender (male: N (%)) |
| Amputation level: toe/great toe | ||||||||
| Ademoglu et al 51 | Turkey | Case–control | Present outcomes (including clinical and biomechanical markers) after replantation surgery of great toe. | 9 | Failed replantation of great toe following trauma | Successful replantation of the great toe | 25.3±14.9 | 8 (89) |
| Beyaert et al 38 | France | Cross-sectional | Determine effects at 5 years of second toe-to-hand transfer on foot morphology and function in children. | 11 | Toe amputation for digital reconstruction to treat congenital hand malformation | NA | 6.5 to 12.5 | 7 (63.6) |
| Chen et al 33 | Taiwan | Case report | Describe a triple toe transfer as a unit with vascular supply. | 1 | Triple toe amputation for finger reconstruction | NA | 26 | 1 (100) |
| Lavery et al 49 | United States | Cross-sectional | Compare under foot pressure with contralateral foot after great toe and first metatarsal amputation. | 11 | Great toe (+ partial first MTA) due to diabetes | NA | 65.1 (39–79)* | 7 (63.6) |
| Lipton et al 37 | United States | Pre-post study | Evaluate gait factors during walking cycle before and after great toe amputation. | 12 | Great toe amputation for thumb reconstruction | NA | 29.3 | 10 (83.3) |
| Mann et al 50 | United States | Cross-sectional | Evaluate clinical and biomechanical effects of great toe amputation. | 10 | Great toe amputation for thumb reconstruction | NA | NR | 9 (90) |
| Poppen et al 40 | United States | Cross-sectional | Establish effect on gait of great toe amputation. | 4 | Great toe amputation for thumb reconstruction | NA | NR | NR |
| Amputation level: metatarsophalangeal (MTP) | ||||||||
| Forczek et al 34 | Poland | Case report | Investigate gait kinematics after bilateral partial amputation of toes. | 1 | Bilateral MTP to treat frostbite | NA | 30 | 1 (100) |
| Amputation level: transmetatarsal (TMT) | ||||||||
| Andersen et al 35 | Denmark | Pre-post study | Report the results of transmetatarsal amputation. | 5 | TMA to treat rheumatoid arthritis | NA | 54.4±5.9 | NR |
| Czerniecki et al 39 | United States | Pre-post study | Describe changes in:(i) function due to limb disability prior to surgery, (ii) premorbid function to 12 months and (iii) identify associations between presurgical risk factors and change in ambulation. | 87 | TMA due to peripheral artery diseases or diabetes | NA | 62.3±8.9 | NR |
| Friedmann et al 41 | United States | Cross-sectional | Evaluate indications for surgical, and post-surgical management of partial foot loss. | 9 | TMA due to diabetes, trauma, frostbite or burn | NA | NR | NR |
| Garbalosa et al 47 | United States | Cross-sectional | Examine effects of TMA on plantar pressure and ankle joint kinematics. | 10 | TMA due to diabetes | NA | 58.3±17.2 | 8 (80) |
| Kelly et al 48 | United States | Cross-sectional | Determine point during gait cycle at which peak forefoot plantat pressures occur. | 24 | TMA due to diabetes | Healthy subjects | 60.3±10.3 | 6 (50) |
| Mueller et al 26 | United States | Cross-sectional | Determine effect of footwear, shoe inserts and ankle foot orthoses on peak plantar pressures of amputated and non-amputated feet of patients with diabetes. | 30 | TMA due to diabetes | NA | 61.7±11.3 | 20 (66.7) |
| Mueller et al 27 | United States | Cross-sectional | Compare function of persons with diabetes and TMA with matched controls. | 30 | TMA due to diabetes | Healthy subjects | 62.4±9.3 | 18 (60) |
| Mueller et al 28 | United States | Cross-sectional | Compare gait characteristics of people with diabetes and TMA to matched controls. | 30 | TMA due to diabetes | Healthy subjects | 62.4±9.3 | 18 (60) |
| Pinzur et al 42 | United States | Cross-sectional | Evaluate the metabolic demand for walking in those with amputation following peripheral vascular disease. | 25 | Midfoot amputation due to peripheral vascular disease | Syme, below, through and above knee amputation and peripheral vascular disease | NR | NR |
| Pinzur et al 43 | United States | Case–control | Establish ground reaction force and dynamic centre of pressure data for those with midfoot and Syme amputation. | 11 | Midfoot amputation due to peripheral vascular disease | Syme and peripheral vascular disease | 63 | NR |
| Salsich et al 29 | United States | Cross-sectional | Determine correlations between strength and functional measures, in people with diabetes and TMA. | 30 | TMA due to diabetes | NA | 61.7±11.3 | 20 (66.7) |
| Tang et al 53 | Taiwan | Case–control | Determine correlations between strength and functional measures and intercorrelation between functional measures in people with diabetes and TMA. | 17 | TMA due to trauma | Healthy subjects | 42.3±4.9 | 17 (100) |
| Amputation level: chopart | ||||||||
| Burger et al 52 | Slovenia | Cross-sectional | Establish gait biomechanics (barefoot; silicone prosthesis with/without footwear; footwear with conventional prosthesis). | 4 | Amputation due to trauma | NA | 42.3±17.2 | 4 (100) |
| Amputation level: ray | ||||||||
| Aprile et al 45 | Italy | Case– control | Investigate differences in gait between persons with diabetes and first ray amputation, persons with diabetes without amputation, and healthy subjects. | 18 | Ray amputation due to diabetes | Diabetes without amputation, healthy subjects | 70.4±6.9† | 12 (66.7) |
| Ramseier et al 54 | Switzerland | Cross-sectional | Discuss clinical reasoning in deciding, planning, and carrying out local tumour resection and reconstruction. | 4 | Toe and ray amputation to treat malignant tumour | NA | 30±28 | 2 (50) |
| Amputation level: mixed | ||||||||
| Burnfield et al 46 | United States | Cross-sectional | Determine impact of two partial foot amputation levels on limb loading force of non-affected limb during gait. | 21 | Toe amputation or TMA due to diabetes | Healthy subjects | NR | 15 (71.4) |
| Dillon et al 30 | Australia | Case– control | (i) Examine if preserving foot length should be a primary objective to maintain normal function, (ii) establish biomechanical data to aid selection of amputation level. | 16 | MPT (1), TMT (1), Lisfranc (4), Chopart (2) amputation due to trauma or gangrene | Healthy subjects | 41.5±24.4 | NR |
| Dillon et al 31 | Australia | Case– control | Evaluate the biomechanical effects of a partial foot prostheses in normalising gait pattern. | 16 | MPT (1), TMT (1), Lisfranc (4), Chopart (2) amputation due to trauma or gangrene | Healthy subjects | 42.1±15.9 | NR |
| Dillon et al 32 | Australia | Case– control | Describe the gait patterns of a range of partial foot amputees to aid understanding of the mechanical adaptations to partial foot amputation and prosthetic fitting. | 7 | MTP (1), TMT (1), Lisfranc (3), Chopart (2) amputation due to trauma or gangrene | Healthy subjects | 40.1±14.9 | NR |
| Greene et al 36 | United States | Cross-sectional | Review gait and function of patients with congenital and childhood-acquired partial foot amputation and Syme amputation. | 14 | Ray, TMT, Midtarsal, Lisfranc, Chopart and Syme’s amputation either congenital or acquired in childhood | NA | 16.3 | 10 (71.4) |
| Kanade et al 44 | United Kingdom | Case– control | Investigate walking capacity, performance and impact on the plantar tissues across four groups with diabetic neuropathy. | 84 | TMT (5), Ray (4), Hallux(5), all five toes (1), first two toes (1) amputation due to diabetes | Diabetic neuropathy/diabetic foot ulcer/trans-tibial amputation | 62.3±7.6 | 74 (88) |
*Only range reported.
†SD not reported for all groups.
MTA, metatarsal amputation; MTP, metatarsophalangeal; NA, not applicable; NR, not reported; TMA, transmetatarsal amputation; TMT, transmetatarsal.