Amputations proximal to the transmetatarsal level often result in considerable gait
problems during walking. This is secondary to the loss of support and push-off.
When performed (often for the diabetic patient and in certain traumas), recent
improvements in preoperative testing (e.g. ultrasound) allow for a relative high accuracy
in predicting which patients will heal. The principle complication of the Lisfranc
amputation is a tendency towards an equinus deformity from the loss of dorsiflexor
attachments. If severe, such a deformity may require repeat amputation at a higher