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From 1993 to 2009, age-adjusted hospital discharge rates for nontraumatic LEA below the knee among the diabetic population decreased for females but showed little or no change until 1995 and then decreased afterwards for males.

Throughout the period, the hospital discharge rates for nontraumatic LEA were higher among men than women.

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Centers for Disease Control and Prevention (CDC), National Center for Health Statistics, Division of Health Interview Statistics, data from the National Health Interview Survey.

Data computed by personnel in the Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, CDC.

Amputation of Toe; Amputation through Metatarsophalangeal Joint; Disarticulation of Toe; Metatarsal Head Amputation; Ray Amputation of Foot (Disarticulation of the Metatarsal Head of the Toe Extending Across the Forefoot just Proximal to the Metatarsophalangeal Crease)Surgical amputation of part or all of a toe usually is necessary because of trauma or diseases associated with poor blood supply or nonhealing ulcers.

Diseases that can cause damage leading to toe amputation include diabetes, peripheral vascular disease, osteomyelitis, injury, infection, impaired immune function, tumors, frostbite, nerve injuries, and congenital deformities.

Interruption of blood supply to the toe (gangrene) may also lead to partial foot amputation necessary to remove (débride) infected or dead (necrotic) tissue.

Foot ulcers caused by diabetes are responsible for 85% of nontraumatic amputation in the lower extremity and toes (up to 15% of individuals with diabetes will experience a foot ulcer during their lifetime) (Pinzur).

Individuals with peripheral neuropathy or those who develop bunions, hammer toes, claw toes, or mallet toe deformities that result in tissue swelling, ulcer formation, and infection are at increased risk for toe amputation.

Also, individuals with impaired autonomic function may develop dry, cracked skin which allows access for bacterial infection that may precede amputation.

Traumatic injury such as crushing, mangling, or partial amputation may block blood supply to such an extent that surgical intervention such as partial traumatic amputation may be necessary.

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