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Syme's amputation: a neglected procedure
1Department of Surgery, Kent and Canterbury Hospital, UK.
Insights
Syme
Area of Science:
- Podiatric surgery
- Vascular surgery
- Orthopedic surgery
Background:
- Syme's amputation is a surgical procedure involving disarticulation at the ankle joint.
- Peripheral vascular disease and diabetic gangrene are common indications for lower limb amputations.
- Previous attempts to revascularize circulation may precede amputation.
Purpose of the Study:
- To review the indications and surgical techniques for Syme's amputation.
- To analyze patient outcomes following Syme's amputation over a 9-year period.
Main Methods:
- Retrospective review of nine patients undergoing ten Syme's amputations over nine years.
- Analysis of patient demographics, underlying conditions, and surgical history.
Main Results:
- Six amputations were for peripheral vascular disease, three for diabetic gangrene, and one for trauma.
- Two patients required a subsequent below-knee amputation.
- One patient with Buerger's disease underwent bilateral Syme's amputations.
Conclusions:
- Syme's amputation is a viable option for specific lower limb conditions, particularly when conservative measures fail.
- Careful patient selection and surgical technique are crucial for optimal outcomes.
- Understanding the indications and potential complications is essential for managing patients requiring Syme's amputation.
Abstract:
Over a 9-year period nine patients underwent Syme's amputation, one patient undergoing a staged bilateral procedure. Six of the ten amputations were carried out for the complications of peripheral vascular disease, including one with Buerger's disease who had bilateral amputations. Three patients had amputations for infected diabetic gangrene and one amputation was performed as a result of trauma. Five patients had previously undergone surgery to improve their peripheral circulation. Two patients required a subsequent below knee amputation. The indications for and technique of Syme's amputation are discussed.
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