Saturday, May 28, 2022

1 of 3: Responses: Symes vs. Chopart

Monica Motloch

Thank you to everyone who responded: very helpful information. FYI: The =
family & orthopedic surgeon have chosen a Symes level amputation. The 15 =
responses are separated into three posts.

Question:
>I want to give as much info to the parents of a 9 yr old girl who=20
>is presently newly amputated at a Choparts level. She is=20
>scheduled for surgery on Tues. for a revision. I have run into=20
>some controversy with this on both sides of the fence, and if it=20
>comes down to personal experience, that’s what I’m looking for!
>
>The parent are deciding to either stay at that level or move up=20
>to a Symes level.
>
>I’m seeking people’s opinions, experience, advise and if there is=20
>any literature that might point to one level being more=20
>functional than another…Pro’s and Con’s, etc.

Answers:out of the 15 responses (posted below), 2 were pro-Chopart and =
8 were pro-Symes.=20
———————————=
—————-
1). “A chopart is an appropriate level for a child if and only if two =
things have occurred in the past. 1. she has had the appropriate =
anterior musculature transfers and/or lengthening of the posterior =
musculature to balance the foot and 2. she has had a surgical or =
congenital bone growth arrest below the knee, allowing the large chopart =
distal end to be at the level of the largest part of the gastroc at the =
end of growth. Also it helps to have the calcaneous slid slightly =
posteriorly to aid suspension of the prosthesis.”=20
-Gary M. Berke MS, CP,FAAOP
———————————=

2). “Symes level is more preferable for a variety of reasons.
1. The amputation is easier to manage from a biomechanical standpoint-=20
Chaopart type amputations have a greater incidence of skin breakdown=20
2. Componentry is easier with a symes level- more foot options.
3. Length considerations for limb length are easier with a symes.
4. Cosmesis is better with a symes- easier to wear normal shoe and =
sneaker.
5. Suspension is better with symes than chopart.”

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