SYME’S AMPUTATION
Syme’s amputation, a technique which is named after the surgeon who invented it, is very suitably for the third world countries where people walk barefooted. There is no need of prosthesis or technical aid such as crutches to be able to walk.
The amputation is actually a disarticulation in the talo-crural joint (the ankle joint proper) followed by removal of the very distal end of the tibia which is cut away with a saw. The soft tissue of the heel is preserved and sutured back to cover the tibial end as a weight bearing cushion.
The incision is wedge shaped preserving the heel. Cut right through to the bones.
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Cut the ankle joint ligaments on both sides, pulling the foot forwards to facilitate dissection. Keep close to the calcaneus and cut away the foot.
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Cut the distal end of the tibia with a saw.
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Cut the tendons short
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Suture the heel back on the tibial end.
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Dress with elastic bandage
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Mobilize immediately with full weight bearing
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