The Syme amputation has not in the past been fully utilized by most surgeons in this country. A Syme amputation which meets all the requirements of good function is the best major amputation in the lower extremity. As such, it has definite advantages over amputation below the knee and over most short foot stumps.
The chief disadvantage is the degree of skill and attention on the part of the surgeon, which are required for the best results. If the Syme amputation does not meet the requirements of good function, or if it cannot be made to do so, amputation below the knee is preferable.
The preoperative indications, the operative technique, and the postoperative care are equally important. It is unfortunate that such a small proportion of patients requiring amputations of the lower extremity have the preoperative indications for this procedure, but the experience gained in observing this group of patients has convinced the authors of the superiority of the Syme stump over other stumps of the lower extremity.
It is recommended strongly that the Syme amputation be performed, whenever possible, instead of the more widely accepted mid-leg amputation.