Syme Amputation and Prosthetic Fitting Challenges

Abstract

Most commonly, Syme amputation is performed in patients with nonhealing diabetic foot ulcers and diabetic vascular disease. The procedure is favored by physicians and patients because it results in a limb that is nearly normal in length, is amenable to fitting with one of several prostheses, provides the potential for full end bearing, and allows patients to expend less energy when walking than in patients with a more proximal amputation. Recent results have shown the Syme procedure to have good results in patients who meet preoperative criteria, particularly for patients younger than 65 years and with an ankle-brachial index of less than 0.5. Access to an experienced prosthetist is essential, and barring complications, most patients can begin ambulating with a prosthesis as soon as 6 weeks postoperatively.