An Improved Prosthesis for a Syme Amputation

A Syme amputation, which is the most conservative below-the-knee amputation and which provides the best functioning stump for weight-bearing, has been rarely recommended for women, because the unsightly prosthesis is objectionable. Some time ago it was necessary to amputate the foot of a female patient, twenty-two years old. After a conference with the young woman, it was decided that the many merits of a Syme amputation far outweighed the objection of the unattractive prosthesis, and an amputation of the Syme type was carried out. A very good stump was obtained, and it was fitted with the conventional prosthesis. Although the artificial limb was most serviceable, it was indeed unsightly and our patient was very unhappy. The problem of finding a more pleasing prosthesis was discussed with our limb maker and, after several attempts, a very neat, light, and functional prosthesis was constructed from laminated plastic material reinforced with glass cloth. After the first lamination or molding, a window was cut out of the back of the prosthesis sufficiently large to allow the stump to slip completely into the socket. Following the last lamination, the open area was closed with a leather lacer. Although the stump had the usual bulbous end, it was possible to make the bulge less apparent by the proper build-up of the shin portion of the prosthesis and by thinning the plastic material in the region of the malleoli during the laminating process. Details of Preparation [1]