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The Syme amputation in children.

W H Davidson, W H Bohne

    The Journal of Bone and Joint Surgery. American Volume
    |October 1, 1975
    PubMed
    Summary
    This summary is machine-generated.

    Syme ankle disarticulation in children promotes proportionate bone and soft tissue growth, enabling prosthetic use within three months. This surgical technique is recommended for specific congenital lower extremity anomalies.

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    Area of Science:

    • Pediatric Orthopedics
    • Surgical Reconstruction
    • Biomedical Engineering

    Background:

    • Congenital lower extremity anomalies pose significant challenges for pediatric patients.
    • Limb-sparing surgeries aim to preserve function and promote normal growth.
    • Syme ankle disarticulation is a surgical option for specific ankle and foot deformities.

    Purpose of the Study:

    • To evaluate the long-term outcomes of Syme ankle disarticulation in children.
    • To assess bone and soft tissue growth, prosthetic ambulation, and complication rates.
    • To determine the efficacy of prosthetic management for secondary deformities like genu valgum.

    Main Methods:

    • Retrospective analysis of 23 children undergoing Syme ankle disarticulation (ages 2-11 years).

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  • Assessment of skeletal growth, soft tissue development, and time to prosthetic ambulation.
  • Documentation of surgical complications, including ischemic necrosis and tendon migration.
  • Evaluation of prosthetic interventions for managing progressive genu valgum in fibular hemimelia.

    • Main Results:

    • All 23 children demonstrated proportionate bone and soft tissue growth post-surgery.
    • Permanent prostheses were utilized by all patients within three months of operation.
    • Two cases of ischemic necrosis occurred due to posterior tibial artery ligation.
    • Suturing extensor tendons to the heel pad prevented posterior migration.
    • Prosthetic realignment successfully managed genu valgum in 10 of 14 affected children.

    Conclusions:

    • Syme ankle disarticulation facilitates normal growth and early prosthetic use in pediatric patients.
    • Careful surgical technique is crucial to avoid complications like ischemic necrosis.
    • Prosthetic management plays a vital role in addressing secondary deformities.
    • Early Syme ankle disarticulation is a viable treatment for select congenital lower extremity anomalies.