Syme's amputation with defective heel

Abstract

The main advantage of Syme's amputation is the end-bearing stump. A defective heel pad often leads to below-knee amputation. The question of interest is whether an atypical cutaneous flap also provides a covering for the stump adaptable to weight-bearing. Thirteen patients with heel pad ulcers or tumors who could not be attended to with a classic Syme's amputation were operated on in a modified fashion. Skin from the dorsum of the foot or a medial flap was used for covering the stump. Two patients underwent transtibial amputation. The remaining 11 patients received a covering for the end of the stump composed of tissue thick and bulky enough for weight-bearing in a prosthesis typical for a Syme stump. The results show that a transtibial amputation can be prevented by atypical soft-tissue coverage of a Syme stump with satisfactory results regarding function and cosmetics.

Syme Amputation: A Systematic Review

“…6,32 Six studies provided data on walking on the bare residual limb: 97 of 234 adults were able to walk a short distance on the bare residual limb (41%; 95% CI, 35%-48%). 6,23,26,31,52,56…”

“…6,32 Six studies provided data on walking on the bare residual limb: 97 of 234 adults were able to walk a short distance on the bare residual limb (41%; 95% CI, 35%-48%). 6,23,26,31,52,56 In the dysvascular group, 135 of 196 (69%; 95% CI, 62%-75%) patients were fitted with a prosthesis. In the traumatic amputees, prosthesis fitting was reported in 90 of 116 (78%; 95% CI, 70%-84%) patients.…”

“… * References 3, 4, 6, 8, 9, 11, 12, 15, 18-23, 25-27, 29, 31-34, 36, 39, 41-44, 48, 51, 52, 54, 56, 60, 61, 63. …”