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Long-term Outcomes Following Syme's Amputation.

Elissa S Finkler¹, Daniel A Marchwiany², Adam P Schiff¹

¹1 Department of Orthopaedic Surgery and Rehabilitation, Loyola University Health System, Maywood, Illinois, USA.

Foot & Ankle International

|April 13, 2017

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Syme's ankle disarticulation amputation offers better long-term outcomes than transtibial amputation, with fewer complications and less need for rehabilitation. Patients achieve improved functional independence and prosthetic fitting is simpler.

Area of Science:

Orthopedic Surgery
Amputation Outcomes
Prosthetic Rehabilitation

Background:

Syme's ankle disarticulation amputation has a low metabolic cost and simpler prosthetic fitting.
Despite potential benefits, objective long-term outcome data are limited.

Purpose of the Study:

To evaluate the long-term functional outcomes and complication rates of Syme's ankle disarticulation amputation.
To compare outcomes with transtibial amputation.

Main Methods:

Retrospective review of 51 patients undergoing Syme's amputation over 23 years.
Patients completed the Short Musculoskeletal Function Assessment (SMFA) for functional, mobility, and bothersome indices.
Analysis included diabetic and nondiabetic etiologies for amputation.

Keywords:

Syme amputation ankle disarticulation diabetes

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Main Results:

Favorable SMFA scores were reported for mobility, function, and bother in contacted patients.
Syme's amputation had lower conversion rates to transtibial amputation compared to some reports.
Diabetic patients had higher mortality and conversion rates than nondiabetic patients.

Conclusions:

Syme's ankle disarticulation amputation demonstrates favorable long-term outcomes, including improved functional independence.
The procedure is associated with lower complication rates and easier prosthetic fitting than previously suggested.
Patients require less rehabilitation, supporting its utility in select cases.