Syme and Boyd Amputations in Children

Abstract

Amputation through the ankle with or without retention of the os calcis is a useful procedure for children with severe congenital anomalies of the lower extremity where the foot is so deformed as to preclude weight– bearing and wearing of normal shoes, or where limb inequality is of such magnitude that standard equalizing procedures are of no avail and walking is possible only with the use of an unappealing prosthetic extension to the shortened extremity (Figs. 10.1 and 10.2).^1,2,7,11,17 Amputation through the ankle, as opposed to amputation through the distal tibia, has the distinct advantage of preserving growth in an already shortened extremity, since the distal tibial growth plate remains undisturbed (Fig. 10.3). It also avoids the problem of bony overgrowth, which is common when amputations are done through the diaphysis or metaphysis of growing bones (Fig. 10.4).