Syme Amputation: A Systematic Review.

Abstract:

BACKGROUND:In the decision-making process toward an amputation of the lower extremity, knowledge about patient-related outcomes after amputation and rehabilitation is important. We have not found a systematic review that provides this knowledge for Syme amputation. The aim of this study was to present an overview of outcomes after a Syme amputation grouped according to the International Classification of Functioning, Disability and Health (ICF) model, focusing on body structures and functions, activities, and participation. METHODS:A systematic literature search was performed. Included studies went through 2 selection procedures by 2 independent assessors. Included were all studies concerning Syme amputation with patient-related outcomes. RESULTS:Thirty-six studies were included for data extraction, concerning 1056 patients (238 children and 818 adults). Heel pad migration was reported in 49 of 176 (28%), skin problems in 23 of 128 (18%), and bone problems in 42 of 145 (29%) children. No reamputations were reported. All children were fitted with a prosthesis, and 62 of 90 (69%) children participated in sports. Skin problems were reported in 35 of 195 (18%), ulceration or infection in 120 of 512 (23%), residual limb pain in 46 of 181 (25%), and reamputations in 180 of 919 (20%) adults. In total, 247 of 363 (68%) adults were fitted with a prosthesis. Walking aids were used by 45 of 135 (33%) adults. Employment status was unchanged in 147 of 209 (72%) adults. CONCLUSION:In children, no reamputations were necessary and few complications were reported, with good participation in daily life in the majority of children. In adults, more complications and reamputations were reported; nevertheless, most adult amputees became successful prosthesis users. LEVEL OF EVIDENCE:Therapeutic Level III, systematic review containing retrospective cohort studies.

journal_name

Foot Ankle Int

authors

Braaksma R,Dijkstra PU,Geertzen JHB

doi

10.1177/1071100717745313

subject

Has Abstract

pub_date

2018-03-01 00:00:00

pages

284-291

issue

3

eissn

1071-1007

issn

1944-7876

journal_volume

39

pub_type

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