Syme Amputation


If you’re faced with the possibility of a foot amputation, you might not know there are different types of amputations available. One such option is the Syme amputation, which involves removing the foot at the joint where the ankle meets it. You’re able to keep the heel pad so you can continue to put some weight on your foot without the use of a prosthetic, but it’s best to still consider using a prosthetic for daily activities. The goal of this type of amputation is to remove the non-usable foot or diseased tissue to create a painless and functional limb.

What’s the History Behind Syme Amputation?

In 1843, pioneering Scottish surgeon James Syme introduced an amputation that he believed gave several advantages over other types of amputations. Before his type of amputation, patients who had injuries or infections of the foot would undergo an amputation directly below the knee. Syme’s process amputates where the foot meets the ankle, and he performed this surgery on a 16-year-old patient who was suffering from osteomyelitis of the foot. He claimed the advantages of this type of surgery include a reduced risk of infection and a more comfortable stump.

When Is Syme Amputation Used?

Syme Amputation & Prosthetics

Image via Flickr by HeelsandFeet

A Syme amputation is used for infection, foot trauma, or tumors in addition to instances when the foot has deformities and must be removed. One main advantage of this type of amputation is that you can allow your leg to bear weight without the use of a prosthetic. Keep in mind that it’s best to use a prosthetic for daily situations, but in a pinch, you should be able to walk from the bedroom to the bathroom without the use of a prosthetic.

When Should Syme Amputation Not Be Used?

In certain situations, a Syme amputation might not be your best option. It’s best to consider other alternatives if you encounter the following issues:

  • You have an infection, trauma, or tumor that involves the ankle. A Syme amputation won’t treat the problem if you have one of those issues with your ankle. You’ll need a higher level of amputation in those instances.
  • You experience poor blood flow with the artery near the heel pad. Having a Syme amputation will prevent the wound from healing properly since the blood flow is inadequate.
  • Your heel pad isn’t intact. If you have any dead tissue, a wound, or an ulcer located on the heel, avoid having a Syme amputation. Consider a higher level of amputation instead.
  • You have a medical condition where the surgery risks outweigh the benefits. If you’re able to improve those specific medical conditions, the Syme amputation might be reconsidered.

What Should You Expect During the Procedure?

During the procedure, ankle and foot orthopedic surgeons work on your foot when you’re under general anesthesia. If you’re someone who has certain risk factors that might cause dangerous situations if you go under general anesthesia, talk with your doctor about possibly having a leg nerve block or spinal anesthesia. The surgeon makes the incision where the ankle and foot meet, making sure to protect the heel pad. The tendons and ligaments connecting the foot to the ankle are cut, and the surgeon removes soft tissues from the bones of the foot.

Next, the surgeon ties and cuts off arteries and removes the ankle’s bony prominences. This gives your leg’s end a flat surface once the wound is closed. Sometimes a drain is used to prevent blood from pooling deep within the tissue. The last step involves applying a soft dressing and cast to the area.

What Is the Recovery Process Like?

After the procedure, you’ll be transferred to the recovery area, and the time of your stay in the hospital varies. You should be able to start walking once the wound heals. If you can safely maneuver mainly on one leg with the use of a front-wheeled walker or crutches and have assistance at home, you should be able to go back home after surgery. If you need more help or physical therapy, you might go directly to a rehab center or nursing home facility before heading home.

Once the wound has healed, the skin sutures or staples are removed. You can manage the swelling by using a compression stocking. However, don’t be alarmed if you have some swelling that can last up to one year after surgery. After most of the swelling has dissipated, you can schedule a meeting with a prosthetist to have a prosthetic created for your stump and lower leg.

How Does Syme Amputation Compare to Other Amputations?

A Syme amputation is similar to a regular below-knee amputation (BKA), and in many instances, these are both viable options. One main difference is that with a Syme amputation, you can walk on your limb without using a prosthetic. This might be extremely beneficial if you need to get up during the night to use the bathroom since you don’t need to place the prosthetic on. Also, Syme amputations allow for easier prosthetic training compared to a BKA because it feels more natural.

The Syme amputation is similar to a Chopart amputation, which is a forefront/midfoot level amputation. It takes place at the midportion of the foot at the midtarsal joint. Both types let you bear weight on the remaining part of the foot, but the main difference is the Syme amputation doesn’t have any of the tarsals conserved. Instead, the procedure is performed through the ankle joint. Another similar foot amputation is the Boyd amputation. With this type of amputation, not only is the heel pad retained but so is the heel bone, also called the calcaneus.

If you have any further questions about the Syme amputation, reach out directly to Scheck & Siress. Since 1953, we have strived to offer quality patient care through our expertise and dedication. We offer 18 convenient locations throughout the Chicago, Illinois, area, so contact us today by phone at (866) 299-6205 or via our secure online messaging system if you’re interested in a free consultation or for more information.