Ankle - Syme's Amputation
Norgren L, Hiatt WR, Dormandy JA, et al.; on behalf of the TASC II Working Group. Inter-society consensus for the management of peripheral arterial disease (TASC II). J Vasc Surg 2007; 45(1): S5a–S66a.
The Rehabilitation of Lower Limb Amputation Working Group, Department of Veterans Affairs and Department of Defense. VA/DoD clinical practice guideline for rehabilitation of lower limb amputation. Version 1.0, 2007.
Step by step
Deep fascial exposure
Mark the skin inferior to the malleoli and connect these points over the anterior side of the ankle in a straight line. Distally, two lines are drawn from the points inferior to the malleoli over the plantar side and these two are connected. This newly drawn line has to run approximately at the level of the calcaneocuboid joint.
Incision line position
The incision line positioned over the anterior side of the ankle should not be placed more proximal than the distal border of the tibia. While incising the plantar line, it is advisable to keep the length of the plantar flap too long which can be shortened and remodeled later on. These are both in order to be able to close the wound.
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