The Syme's amputation differs from a standard below-knee amputation in that it involves:

• A Disarticulation at the ankle joint with preservation of the heel pad for end-bearing ✓
• B Disarticulation at the knee with retention of the femoral condyles
• C Transmetatarsal amputation with plantar flap closure
• D Hip disarticulation with myodesis of gluteal muscles

Explanation

Syme's amputation is a disarticulation at the ankle level with removal of both malleoli and preservation of the heel pad (calcaneal fat pad) to provide a robust end-bearing residual limb. The heel pad can bear full body weight, allowing limited ambulation without a prosthesis. The Syme's prosthesis is a low-profile device worn inside a shoe. Advantages: end-bearing capacity, preserved limb length, and good functional outcomes. Disadvantages: bulky ankle region making cosmetic prosthetic fitting difficult. It is preferred in dysvascular disease of the foot when the heel pad vascularity is preserved.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.