Disarticulation of the ankle, removal of malleoli, and attachment of heel pad to weightbearing area. Heel pad must be intact for weight bearing and be adequately perfused.
Indicated for loss of tissue viability (usually from infection, gangrene, trauma)
Allows the use or a cosmetically acceptable prothesis.
Generally will not heal without a palpable posterior tibial pulse.
70% have a good functional outcome – may be dependent of prothesis fitting and fat pad migration. Much less rehabilitation is needed for a Syme’s than a below knee amputation.
Complication- delayed wound healing; fat pad migration; painful neuroma