Document Type

Article

Publication Date

2026

Abstract

Lower extremity ischemia is a limb threatening condition that can result in tissue loss, infection, and amputation; particularly in older patients with existing peripheral vascular disease or diabetes. Pain, delayed recognition of injury, and social determinants of health often complicate management and influence patient decision making. This case study reviews a 73-year-old male who presented with a severe thermal burn injury to the right foot after prolonged exposure to a heating device during their sleep. The patient's protective sensation was impaired due to diabetic peripheral neuropathy. He also has a history of a left below knee amputation (BKA) and poorly controlled pain. This case showcases how pedal acceleration time (PAT) can be utilized to provide additional diagnostic information beyond traditional measures. While he initially refused further amputation done, these clinical findings from imaging results and multidisciplinary consultation contributed to the patient’s decision to proceed with a right transmetatarsal amputation (TMA).

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