Twenty-one patients who had had twenty-three Syme amputations at an
average age of four years and eleven months were studied to assess their
physical and psychological functional status. Physical evaluation was based
on a timed fifty-yard (45.7-meter) dash, Cybex testing of quadriceps and
hamstring function, and history of sports participation. Psychological
function was based on four psychological tests. Quadriceps power correlated
closely with athletic function. Excessive genu valgum caused a noticeable
abnormality of gait. Migration of the heel pad did not cause problems with
gait. Better psychological function correlated with better orthopaedic
function. The level of family stress was the predominant factor that
influenced test results relative to behavior, self-concept, and
intelligence quotient. As a result of this study, we believe that a Syme
amputation in a young patient may be compatible with athletic and
psychological function closely approaching that of a non-handicapped child
of the same age.