Syme’s amputation is an ankle disarticulation (the removal of the foot through the joint) with removal of the malleoli (the two rounded protrusions on either side of the ankle) then forward rotation of the heel pad over the end of the residual tibia. There is considerable difference of opinion regarding the merits of the Syme’s amputation. Some people with a Syme’s amputation have difficulty wearing a prosthesis, while others do very well. As with other partial foot amputations, revision surgery is sometimes necessary in order for the person to successfully use a prosthesis.
A rigid prosthetic socket is an important part of fitting a Syme’s amputation. The socket has a soft interior liner and usually extends up to just below the person’s knee. Other socket designs that are sometimes used include the Canadian Syme and the bladder-type Syme. The Canadian Syme has an opening in the back, making it easier to put on.
The short space between the end of the residual limb and the floor means that a standard prosthetic foot usually has to be modified in order to fit correctly. Possible foot choices include the Solid Ankle Cushion Heel (SACH) foot or a carbon reinforced energy-storing foot.