Primary closure with a filleted hallux flap after transmetatarsal amputation of the big toe for osteomyelitis in the diabetic foot: a short series of four cases.

In the diabetic foot, osteomyelitis of the first metatarsal head adjacent to a malum perforans may require resection of the metatarsophalangeal joint. This results in a dysfunctional great toe and large tissue defects that take a long time to heal. The authors postulated that transmetatarsal amputation followed by primary closure with a filleted hallux flap would be feasible in selected cases.