Syme's amputation. A review of sixty-seven cases.

نویسندگان

G C Baker

P G Stableforth

چکیده

James Syme described his amputation through the ankle in 1843. He had used it for tuberculosis of the tarsus, for compound fracture-dislocation of the talus and for other severe injuries of the tarsus not suitable for more distal amputation. He considered that when it was feasible it had many advantages over below-knee amputation. He deemed it “ safer and more seemly,” avoiding the problem of stump neuromata, and providing a natural, comfortable end-bearing stump. in the 125 years that have followed, the Syme amputation has enjoyed considerable popularity in Canada and in Scotland, but it has often been held incapable of providing a durable stump. It is passed from one surgical book to another that ulceration of the heel pad leads to the need for more proximal amputation in five to ten years. The concentration of amputee services for the south-east of Scotland at the Princess Margaret Rose Hospital in Edinburgh has provided an opportunity to assess the late results of this operation in most patients who have undergone this amputation in the last eighty years and who now attend the centre from time to time for attention to their prostheses; all these patients have been examined by one or other of us. We have also seen the records of all patients now attending after below-knee amputation, looking among them for cases of Syme’s amputation in which healing had occurred but further amputation had become necessary.

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