Perspectives in Vascular Surgery and Endovascular Therapy

 

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Perspectives in Vascular Surgery and Endovascular Therapy, Vol. 10, No. 2, 89-95 (1999)
DOI: 10.1177/153100359901000212

Syme Amputation

Fred A. Weaver

Division of Vascular Surgery, University of Southern California School of Medicine, Los Angeles, CA

Richard B. Chambers

Orthopaedic Diabetes Service, Rancho Los Amigos Medical Center, Downey, CA

Douglas B. Hood

Department of Surgery, Division of Vascular Surgery, University of Southern California School of Medicine, Los Angeles, CA

The Syme's amputation is infrequently performed in patients with peripheral arterial occlusive disease due to concerns regarding poor wound heal ing, stump ulceration, and the need for ultimate revision to a higher level of amputation. However, this amputation provides a significant advantage for rehabilitation due to energy requirements for ambulation that are significantly reduced compared to alternative amputations at a higher level. The Syme's amputation is an excellent choice for patients with forefoot gangrene or infec tion not amenable to digital or transmetatarsal amputation and who have an intact heel pad. Careful preoperative assessment of blood supply and possible preliminary revascularization may be necessary to avoid ischemic complications of wound healing. Syme's amputation is suitable even for diabetic patients with peripheral neuropathy and provides a durable weight-bearing surface for ambu lation with a prosthesis.

Key Words: Syme's amputation • diabetes • rehabilitation


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