Presentation
Status post amputation.
Patient Data
Radiographs shows amputation/disarticulation at the level of the ankle joint, consistent with Syme amputation. Heel fat pad is preserved.
Case Discussion
In a Syme amputation, the disarticulation is at the tibiotalar joint with resection of the malleoli and preservation of the heel pad 1. It is indicated in various foot and ankle disorders including trauma, malignancy, ischemia, infection, and congenital anomalies. An advantage to the Syme amputation is that it can potentially bear weight without prosthesis and there is proprioception due to preservation of the heel pad 2. However, it can result in heel pad migration and ulcerations. The small leg length discrepancy may seem advantageous but may limit use of certain prostheses. This is not to be confused with a terminal Syme amputation which is through the distal phalanx of the great toe 3.
Acknowledgements: Case submitted by Nora Laban in collaboration with Omar Anwar-Hashmi (Loyola University Chicago).
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