Syme Ankle Disarticulation in Patients With Diabetes

Predictors of major lower limb amputation in children presenting to a single tertiary centre with perceived or true food allergies

“…(16) Low albumin levels were also found to be associated with poor wound healing after Syme amputations, leading to major lower limb amputation in patients with DM. (17) In conclusion, the present study showed that a duration of T2DM ≥ 10 years, positive bacterial culture and low serum albumin levels were predictors for major lower limb amputation in patients admitted with diabetic foot problems. Hence, we recommend early aggressive treatment for infections in patients with a long history of T2DM who are admitted for diabetic foot problems, without neglecting their clinical management and nutritional support.…”

Case Report and Surgical Technique: Closure with a Filleted Hallux Flap after Transphalengeal Amputation of the Big Toe for Osteomyelitis in the Diabetic Foot

“…Hemoglobin levels of more than 10 g/dL and serum albumin of more than 25 g/L are important to ensure good post operative wound healing 10 .…”

A Surgeon’s Perspective on Lower Extremity Amputation and Rehabilitation

“…Criteria to have the Syme amputation include: ability to walk with a prosthesis following surgery, viable heel pad without infection, and enough vascular inflow to support wound estimated by ankle-brachial-indices > 0.5 in diabetics and 0.45 in non-diabetes [18][19]. A key component in quality outcomes after Syme amputation is a modification that attaches the heel pad to the distal tibia thus preventing migration and complicated prosthesis fitting [20]. Distal to the Syme amputation exist numerous options for treating forefoot and mid foot problems requiring amputation.…”

“…The authors note the obvious possible flaw of those with a more distal amputation had less severe disease and thus were able to ambulate with more independence. Following Syme amputation, minimal gait training is required to return to ambulation, thus they are more likely to return to walking independence than the transtibial amputee [20]. Pinzur's study from 2003 revealed only 2/82 patients who had a Syme amputation were unable to ambulate with a prosthesis.…”