In a transmetatarsal amputation, what gait deviation is typically observed?

In a transmetatarsal amputation, the most commonly observed gait deviation is absent push off. This occurs because the amputation typically removes the metatarsal heads and associated soft tissue structures, leading to significant loss of the foot's ability to generate push-off power during the late stance phase of gait. The pushoff phase is crucial for forward propulsion, and without a functioning forefoot, the individual cannot effectively use the toes to propel themselves forward.

This alteration directly affects the efficiency of ambulation, resulting in a more energy-consuming gait pattern. Patients may also compensate by altering their walking mechanics, such as relying more on hip flexion or activating more proximal muscles to move forward, but the hallmark deviation remains the absence of push-off. Thus, this gait adaptation highlights the functional impairments resulting from the loss of forefoot structure and function in the context of transmetatarsal amputation.