We compared the results in fourteen children in whom part of the foot
was amputated with the results in a similar group of patients who had a
Syme amputation. Based on levels of activity, physical examination,
prosthetic requirements, ratio of the length of the fore part of the foot
to the hind part, and gait mechanics, we classified the children into three
groups. In Group I (patients with a metatarsal ray or transmetatarsal
amputation) the results were clearly superior to those in the group with
Syme amputation. In Group II (patients with a Lisfranc, mid-tarsal, or
Chopart amputation and no equinus contracture) the patients had better
over-all function but needed to make greater adjustments for gait than did
those with a Syme amputation. In Group III (patients with a Chopart
amputation who had an equinus contracture and inadequate length of the fore
part of the foot) the results were clearly inferior to those of patients
with a Syme amputation.