Syme and his amputation

The study examines Syme's indications for and technique of amputation at the ankle and reviews the outcome of cases operated on by him for the years 1841-1866. Sources are the Ward Journals and the General Registers of Patients of the Royal Infirmary of Edinburgh for the period under review together with abstracts from contemporary medical journals and surgical textbooks. Ninety-eight cases are included in the study, of which 87 survived and 11 died in the post-operative period. The principal indication for this amputation was 'caries' and the nature of this disorder is outlined. Syme's operative technique is described together with variations recommended by other contemporary surgeons. Syme introduced amputation at the ankle joint with the object of reducing mortality and providing a better stump in cases of disease and injury to the foot. The figures from this study conclude that he was justified on both counts.