CPT® Code 28810

Amputation of the toe with all or a portion of the metatarsal, commonly referred to as a ray amputation, is a surgical procedure that involves the removal of a toe along with the associated metatarsal bone. This type of amputation is frequently performed on patients with diabetes who experience vascular complications, such as ulceration and infection, which can compromise the health of the toe and surrounding structures. The procedure begins with an incision made over the affected metatarsal and toe, allowing the surgeon to access the underlying tissues. The soft tissues are carefully dissected to expose the bones, ensuring that the surgical field is adequately prepared for the amputation. Depending on the severity of the condition, the surgeon may choose to remove the entire metatarsal or only a portion of it. In cases where the entire metatarsal is excised, the tarsometatarsal joint capsule is incised, and the metatarsal is completely detached from its connections. Conversely, if only a portion of the metatarsal is removed, an osteoperiosteal flap is elevated, and the metatarsal is transected at the appropriate site. After the bone is cut, it is smoothed with a file to eliminate any sharp edges or bony prominences that could lead to complications during recovery. The osteoperiosteal flap is then sutured over the exposed diaphysis of the metatarsal to promote healing. Finally, the soft tissues are rearranged as necessary to provide adequate coverage for the remaining portion of the metatarsal, and the incision is closed in layers. A soft bulky dressing is applied to protect the surgical site and facilitate the healing process.