How does a small foot wound lead to an leg amputation?

This week, new broke that TV legend Bert Newton has had his leg amputated recently due to a toe infection starting last december 2020. He was in hospital for 6 weeks leading up to the life threatening decision to remove his lower limb.

You may be wondering, how could a little harmless toe infection lead to a full blown below knee, leg amputation?

There are a few main components that lead to leg amputations. Generally a wound develops, often under the foot or on the ankle bone. Without access to good wound care, an infection can develop. This can be a skin infection or a bone infection. In a healthy individual, with god wound care, antibiotics and some pressure relief, the wound will usually heal. But if the patient has a compromised immune system, getting the wounds to heal can be difficult. This is very true for patients with poorly controlled diabetes. This is because Diabetes can affect your feet in three main ways:

  1. Sensations are not felt in the feet (peripheral neuropathy of the nerves)

  2. Slow healing rate due to poor blood flow

  3. Compromised skin integrity (dry or cracked)

So basically if you can’t feel and can’t heal a small cut or open cracks in the heel, it may be a portal for infection. The infection can then travel into the blood or into bone further up the leg if left unchecked or unattended.

Imagine this scenario... you are a long term diabetic, you haven’t looked at your own feet or had your feet assessed by a Podiatrist in years, you might not know how diabetes affects the feet. You’re walking around the house barefoot and accidentally step on something sharp… The only thing is, you don’t feel anything at all - because you are totally unaware your protective sensations have dulled and reduced in the past few years.

It’s 5 days down the track and you actually notice… fresh blood and some dried blood around the floor of the house? That’s odd. You inspect closer and notice there’s blood on your socks and shoes. You smell a bad odour. You peel off the white sock with blood stains on it and realise that there’s a deep but small wound on the bottom of your foot.

Sounds unbelievable but that dangerous combination of can’t feel and can’t heal is scary and this really does happen.

If this scenario ever happened to the client, they would most definitely need to be admitted to hospital immediately. Complications from wounds could be ongoing management of the wound or ulcer from further deteriorating. If the infection has entered the bone, and antibiotic therapy is not reducing the infection and the clients healing rate is poor, then a surgical amputation may be necessary.

Some interesting facts below on Diabetes are:

  • 280 Australians are diagnosed with diabetes every day. That’s one person every five minutes

  • Around 1.8 million Australians have diabetes.

  • In 2005, more than 1000 people with diabetes died as a direct result of foot ulcers and lower limb wounds – around 8% of all diabetes related deaths.

  • About 50% of patients undergoing nontraumatic lower-limb amputations have diabetes. These patients have a high mortality following amputation, ranging from 39% to 80% at 5 years.

  • Around 85% of diabetes related amputations are preventable if wounds are detected early and managed appropriately.

This is why seeing your local podiatrist for even just a minor cut or infection is important, especially if you have Diabetes. We assess our Diabetic patients annually or more regularly if required, checking for a change in your blood flow, nerves and footwear. It’s much easier to prevent this same story happening as prevention is the best medicine.

This post was inspired by the recent events with Bert’s lower limb health and we hope that it also sheds light to the importance of having your feet checked and diabetes assessed. And if you do have a cut or wound that is not healing, please get it checked out ASAP by your trusted health professional.