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Review Question - QID 214078

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QID 214078 (Type "214078" in App Search)
A 65-year-old male presents to your office with complaints of a non-healing plantar forefoot ulcer. He has undergone several operative debridements as well as total contact casting with percutaneous Achilles tendon lengthening. He has a significant medical history of being a two pack-per-day smoker for 40 years, morbid obesity, hypertension, hyperlipidemia, and insulin-dependent diabetes. His most recent hemoglobin A1C was 8.5. Vascular examination demonstrated a 1+ dorsalis pedis pulse and a 2+ posterior tibial pulse. An amputation at which level would most likely lead to an increased failure rate and need for revision amputation?