Though the decision-making process prior to a lower-limb amputation requires knowledge about patient-related outcomes and rehabilitation, little information appears to be available regarding outcomes after a Syme’s amputation. The aim of a systematic review published online January 10 in the journal of Foot & Ankle International was to present an overview of outcomes after a Syme’s amputation, grouped according to the International Classification of Functioning, Disability and Health (ICF) model, which focused on body structures and functions, activities, and participation.
Thirty-six studies were included for data extraction, concerning 1,056 patients (238 children and 818 adults). Heel pad migration was reported in 49 of 176 (28 percent) of the included patients and skin problems were reported in 23 of 128 (18 percent). Skin problems were reported in 35 of 195 (18 percent) participants; ulceration or infection in 120 of 512 (23 percent); and residual limb pain occurred in 46 of 181 (25 percent) of those studied.
Bone problems were reported in 42 of 145 (29 percent) of children, however no further amputations in children were reported, the study found. All children were fitted with prostheses, and 62 of 90 (69 percent) of the children in the study participated in sports.
Additional amputations were needed in 180 of 919 (20 percent) of the adults. In total, 247 of 363 (68 percent) of adults were fitted with prostheses, the study found. Walking aids were used by 45 of 135 (33 percent) of adults. Employment status was unchanged in 147 of 209 (72 percent) of adults.
Among the children, few complications were reported, with good participation in daily life. Though more complications and additional amputations were reported in adults, most did become successful prosthesis users, the study found.