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Q: Medical question about amputations due to diabetes ( Answered,   0 Comments )
Subject: Medical question about amputations due to diabetes
Category: Health
Asked by: rebeccasurrett-ga
List Price: $2.00
Posted: 09 Mar 2005 09:42 PST
Expires: 08 Apr 2005 10:42 PDT
Question ID: 489376
Word sounds like Simes amputation of right foot
Subject: Re: Medical question about amputations due to diabetes
Answered By: thx1138-ga on 09 Mar 2005 09:56 PST
Hello rebeccasurrett and thank you for your question.

The word you are looking for is "Syme's" see:

"Syme's amputation
Also known as:
Syme's operation

Associated persons:
James Syme

An amputation at the ankle with removal of the malleoli and formation
of a heel flap. Before this technique, the common surgical method for
compound fractures of the tibia and fibula was to amputate at the
thigh. The significant outcome of Syme's technique, in respect to
prostheses, was that the patient had a foundation to walk on instead
of cutting off the entire leg. The full length of the shank provided
the typical weight bearing of a normal heel, with sensation and
proprioception (the capability to sense where your leg is in space)
that was not available before."

Also see:

"Syme's operation

Syme's operation is the best amputation for patients with extensive
non-ischaemic damage to the forefoot. The stump that is produced has
the advantage of allowing considerable weight bearing, and thus allows
considerable independence in the home without a prosthesis. It may
suffice alone in areas where prostheses are not available. The defects
of the procedure used to be difficulty in fitting a foot prosthesis
because of lack of clearance from the ground, which has now been
overcome, and poor cosmesis of the prosthesis in females, due to the
thickness at the ankle: this is still a problem. There is a difference
between the technique that can be used in children and in adults
although the incisions used are similar (Fig. 3) 401. In children the
amputation uses the same heel flap to cover the end of the stump, but
the amputation itself can consist of simple disarticulation of the
talus, followed by removal of the malleoli, leaving behind most of the
joint surface. In adults the incision is made as shown in Fig. 3 401.
The anterior incision is then deepened through the anterior tendons to
allow disarticulation of the talus from the joint. The Achilles tendon
is divided posteriorly and the talus and calcaneum are then dissected
free from the heel by sharp dissection, staying close to the
periosteum to avoid damage to vascular structures. The dissection is
particularly difficult over the thin skin at the back of the heel, and
there is a danger of ‘buttonholing’ the skin, which can
again be avoided by staying close to the periostium. A variant
operation described by Boyd is to leave a slice of the calcaneum
attached to the heel skin, which can then be attached to the proximal
cut bones in a similar manner to the Gritti-Stokes operation. This may
lessen the trauma to the tissue but lengthens the stump"

Thank you for your question and if you need any clarification of my
answer, do not hesitate to ask before rating my answer.

Very best regards


Search strategy included:
diabetes "types of amputation"
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