The Syme's amputation: a correlation of surgical technique and prosthetic management with an historical perspective.

In 1843, James Syme introduced an amputation which he believed had numerous advantages over more proximal amputations. Despite these claims, utilization of the Syme's amputation has been limited due to a less than ideal compatibility of the surgical result with prosthetic design and function. In this article, the history of the Syme's amputation is reviewed along with indications and surgical technique. Modifications to the original surgical procedure are discussed as well as advantages and disadvantages inherent to the Syme's amputation. A description of the biomechanical function of the residual limb/prosthesis and management of the Syme's amputee is provided emphasizing the quest for an ideal prosthesis which is found, could very well allow Dr. Syme's amputation to reach the potential as he had originally envisioned.