A Symes amputation is a surgery that is performed through the ankle joint. The ultimate goal is to remove the foot, while saving the heel pad, which allows the patient to bear weight without prosthesis. Symes amputations are performed when diseased tissue needs to be removed, so that a painless functional limb exists. This sort of amputation is performed when limb deformities, foot trauma, tumours or infection prevent the foot from being saved.
The patient is put under general anaesthesia while the surgery is being done, unless there are risk factors that would make general anaesthesia dangerous. In that case, the surgery can be performed with a spinal tap or nerve block, while the patient is sedated. Sometimes a tourniquet is used to reduce blood loss.
The specific technique used to perform the amputation is as follows:
1. An incision is made where the ankle and foot adjoin.
2. The heel pad is safeguarded.
3. The tendons and ligaments that attach the foot to the ankle are severed.
4. The soft tissue is removed from the bones in the foot.
5. The arteries are tied off and then cut.
6. The bony protuberances on the ankle are removed, which allow the end of the leg to have a flat surface after the wound is closed.
7. Most likely a drain will be used, to ensure that blood pools do not develop deep inside the tissue.
8. A dressing and cast are applied.
After the surgical wound has healed and most of the swelling has gone away, prosthesis will be made and fitted onto the stump and lower leg. The prosthesis will usually need to be adjusted many times, until it is properly fitted. After the prosthesis is applied physical therapy is necessary to help the patient walk correctly. When the patient becomes comfortable with the prostheses, they can most likely return to the majority of the activities they participated in before the amputation.
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2019-06-10 07:31:06