A Syme's amputation (ankle disarticulation) is advantageous over a transtibial amputation primarily because:
- A The prosthesis is easier to fit and cosmetically superior to a transtibial prosthesis
- B It preserves the gastrocnemius muscle for better energy return during gait
- C It provides end-bearing capability through the heel pad, allowing limited ambulation without a prosthesis ✓
- D It is indicated for all diabetic foot amputations because it eliminates phantom limb pain
Correct answer: C. It provides end-bearing capability through the heel pad, allowing limited ambulation without a prosthesis
Explanation
The Syme's amputation preserves the heel fat pad, which is weight-bearing and durable. The resulting residual limb can bear direct end-loading, enabling limited household ambulation without a prosthesis — critical for patients who may lose their prosthesis overnight or in emergencies. The prosthesis required is bulkier than a transtibial prosthesis and has poorer cosmesis. Gastrocnemius is not preserved in Syme's. Phantom limb pain is not eliminated.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
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Written and medically reviewed by the StethoPrep medical team.