Surgical Techniques   |    
The Pirogoff Amputation for Necrosis of the ForefootSurgical Technique
A.R.J. Langeveld, MD1; D.E. Meuffels, MD2; R.J. Oostenbroek, PhD1; M.T.C. Hoedt, MD1
1 Nieuwe Binnenweg 168, 3015 BH Rotterdam, The Netherlands. E-mail address: aernoutlangeveld@gmail.com
2 Department of Orthopedic Surgery, Erasmus MC Rotterdam, Postbus 2040, 3000 CA Rotterdam, The Netherlands
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DISCLOSURE: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Investigation performed at the Department of Orthopedic Surgery, Erasmus MC, University Medical Center Rotterdam, The Netherlands
The original scientific article in which the surgical technique was presented was published in JBJS Vol. 92-A, pp. 968-72, April 2010
The line drawings in this article are the work of Joanne Haderer Müller of Haderer & Müller (biomedart@haderermuller.com)

Copyright © 2011 by The Journal of Bone and Joint Surgery, Inc.
JBJS Essential Surgical Techniques, 2011 Mar 16;93(Supplement 1):21-29. doi: 10.2106/JBJS.J.01132
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The Pirogoff amputation creates a full-weight-bearing stump. It establishes osseous continuity between the tibial plafond and the rotated calcaneus and preserves the heel pad. This advantage is attractive for elderly, low-demand patients who have already undergone a previous contralateral amputation1. A prosthesis does not have to be worn for short walks from room to room or midnight toilet visits, as the patient can use crutches only. In less-developed countries, prosthetic fitting is often unavailable. It is especially in these countries that the Pirogoff amputation can be a good option for patients who have a severe lesion of the forefoot due to trauma. In this group, the Pirogoff calcaneotibial arthrodesis allows painless walking without a prosthesis, with only a slight leg-length discrepancy.
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