Abstract
The transmetatarsal amputation (TMA) is a commonly used procedure in salvage of the diabetic foot. The goal of the procedure is to provide a plantigrade foot that can fit into a shoe with appropriate insole and allow the patient to continue ambulating with a low risk of ulceration. This goal can be achieved with appropriate tendon balancing to avoid development of or address existing equinovarus deformity, a commonly reported complication of the TMA (1–4). To prevent this deformity, several authors have recommended a combination of Achilles’ tendon lengthening or gastrocnemius recession along with tibialis anterior tendon transfer (2–6).
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