22 - syme's amputation

- includes ankle disarticulation, removal of malleoli, & anchoring heel pad to the wt bearing surface) allows execellent gait
with a cosmetic prosthesis;

- symes amputations will not heal w/o palpable posterior artery pulse;
- surgery may be performed in 2 stages;
- most common indication for this is infection;

- ankle is disarticulated in the first stage and the amputation is revised approximately 6 weeks later during the second stage;

- components of the 2nd stage include resection of the malleoli flush w/ joint surface, fixation of the fat pad to residual bone,
and revision of redundant skin;

- this amputation allows for intermittent wt bearing; however, skin break down may occur if a prosthesis is used on a regular basis;

- majority of patients w/ Syme's amputation will require prothesis designed to relieve end weight bearing;