Table 2

Characteristics of the included studies

AuthorCountryStudy designAim(s)Sample sizeExperimental groupControl groupAge in years
(male: N (%))
Amputation level: toe/great toe
Ademoglu et al 51 TurkeyCase–controlPresent outcomes (including clinical and biomechanical markers) after replantation surgery of great toe.9Failed replantation of great toe following traumaSuccessful replantation of the great toe25.3±14.98 (89)
Beyaert et al 38 FranceCross-sectionalDetermine effects at 5 years of second toe-to-hand transfer on foot morphology and function in children.11Toe amputation for digital reconstruction to treat congenital hand malformationNA6.5 to 12.57 (63.6)
Chen et al 33 TaiwanCase reportDescribe a triple toe transfer as a unit with vascular supply.1Triple toe amputation for finger reconstructionNA261 (100)
Lavery et al 49 United StatesCross-sectionalCompare under foot pressure with contralateral foot after great toe and first metatarsal amputation.11Great toe (+ partial first MTA) due to diabetesNA65.1 (39–79)*7 (63.6)
Lipton et al 37 United StatesPre-post studyEvaluate gait factors during walking cycle before and after great toe amputation.12Great toe amputation for thumb reconstructionNA29.310 (83.3)
Mann et al 50 United StatesCross-sectionalEvaluate clinical and biomechanical effects of great toe amputation.10Great toe amputation for thumb reconstructionNANR9 (90)
Poppen et al 40 United StatesCross-sectionalEstablish effect on gait of great toe amputation.4Great toe amputation for thumb reconstructionNANRNR
Amputation level: metatarsophalangeal (MTP)
Forczek et al 34 PolandCase reportInvestigate gait kinematics after bilateral partial amputation of toes.1Bilateral MTP to treat frostbiteNA301 (100)
Amputation level: transmetatarsal (TMT)
Andersen et al 35 DenmarkPre-post studyReport the results of transmetatarsal amputation.5TMA to treat rheumatoid arthritisNA54.4±5.9NR
Czerniecki et al 39 United StatesPre-post studyDescribe 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.87TMA due to peripheral artery diseases or diabetesNA62.3±8.9NR
Friedmann et al 41 United StatesCross-sectionalEvaluate indications for surgical, and post-surgical management of partial foot loss.9TMA due to diabetes, trauma, frostbite or burnNANRNR
Garbalosa et al 47 United StatesCross-sectionalExamine effects of TMA on plantar pressure and ankle joint kinematics.10TMA due to diabetesNA58.3±17.28 (80)
Kelly et al 48 United StatesCross-sectionalDetermine point during gait cycle at which peak forefoot plantat pressures occur.24TMA due to diabetesHealthy subjects60.3±10.36 (50)
Mueller et al 26 United StatesCross-sectionalDetermine effect of footwear, shoe inserts and ankle foot orthoses on peak plantar pressures of amputated and non-amputated feet of patients with diabetes.30TMA due to diabetesNA61.7±11.320 (66.7)
Mueller et al 27 United StatesCross-sectionalCompare function of persons with diabetes and TMA with matched controls.30TMA due to diabetesHealthy subjects62.4±9.318 (60)
Mueller et al 28 United StatesCross-sectionalCompare gait characteristics of people with diabetes and TMA to matched controls.30TMA due to diabetesHealthy subjects62.4±9.318 (60)
Pinzur et al 42 United StatesCross-sectionalEvaluate the metabolic demand for walking in those with amputation following peripheral vascular disease.25Midfoot amputation due to peripheral vascular diseaseSyme, below, through and above knee amputation and peripheral vascular diseaseNRNR
Pinzur et al 43 United StatesCase–controlEstablish ground reaction force and dynamic centre of pressure data for those with midfoot and Syme amputation.11Midfoot amputation due to peripheral vascular diseaseSyme and peripheral vascular disease63NR
Salsich et al 29 United StatesCross-sectionalDetermine correlations between strength and functional measures, in people with diabetes and TMA.30TMA due to diabetesNA61.7±11.320 (66.7)
Tang et al 53 TaiwanCase–controlDetermine correlations between strength and functional measures and intercorrelation between functional measures in people with diabetes and TMA.17TMA due to traumaHealthy subjects42.3±4.917 (100)
Amputation level: chopart
Burger et al 52 SloveniaCross-sectionalEstablish gait biomechanics (barefoot; silicone prosthesis with/without footwear; footwear with conventional prosthesis).4Amputation due to traumaNA42.3±17.24 (100)
Amputation level: ray
Aprile et al 45 ItalyCase– controlInvestigate differences in gait between persons with diabetes and first ray amputation, persons with diabetes without amputation, and healthy subjects.18Ray amputation due to diabetesDiabetes without amputation, healthy subjects70.4±6.9†12 (66.7)
Ramseier et al 54 SwitzerlandCross-sectionalDiscuss clinical reasoning in deciding, planning, and carrying out local tumour resection and reconstruction.4Toe and ray amputation to treat malignant tumourNA30±282 (50)
Amputation level: mixed
Burnfield et al 46 United StatesCross-sectionalDetermine impact of two partial foot amputation levels on limb loading force of non-affected limb during gait.21Toe amputation or TMA due to diabetesHealthy subjectsNR15 (71.4)
Dillon et al 30 AustraliaCase– 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.16MPT (1), TMT (1), Lisfranc (4), Chopart (2) amputation due to trauma or gangreneHealthy subjects41.5±24.4NR
Dillon et al 31 AustraliaCase– controlEvaluate the biomechanical effects of a partial foot prostheses in normalising gait pattern.16MPT (1), TMT (1), Lisfranc (4), Chopart (2) amputation due to trauma or gangreneHealthy subjects42.1±15.9NR
Dillon et al 32 AustraliaCase– controlDescribe the gait patterns of a range of partial foot amputees to aid understanding of the mechanical adaptations to partial foot amputation and prosthetic fitting.7MTP (1), TMT (1), Lisfranc (3), Chopart (2) amputation due to trauma or gangreneHealthy subjects40.1±14.9NR
Greene et al 36 United StatesCross-sectionalReview gait and function of patients with congenital and childhood-acquired partial foot amputation and Syme amputation.14Ray, TMT, Midtarsal, Lisfranc, Chopart and Syme’s amputation either congenital or acquired in childhoodNA16.310 (71.4)
Kanade et al 44 United KingdomCase– controlInvestigate walking capacity, performance and impact on the plantar tissues across four groups with diabetic neuropathy.84TMT (5), Ray (4), Hallux(5), all five toes (1), first two toes (1) amputation due to diabetesDiabetic neuropathy/diabetic foot ulcer/trans-tibial amputation62.3±7.674 (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.