Syme Ankle Disarticulation in Patients With Diabetes

Pinzur, Michael S.; Stuck, Rodney M.; Sage, Ronald A.; Hunt, Nathan A.; Rabinovich, Zinoviy

doi:10.2106/00004623-200309000-00003

Cited by 90 publications

(74 citation statements)

References 8 publications

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“…(16) Low albumin levels were also found to be associated with poor wound healing after Syme amputations, leading to major lower limb amputation in patients with DM. (17) In conclusion, the present study showed that a duration of T2DM ≥ 10 years, positive bacterial culture and low serum albumin levels were predictors for major lower limb amputation in patients admitted with diabetic foot problems. Hence, we recommend early aggressive treatment for infections in patients with a long history of T2DM who are admitted for diabetic foot problems, without neglecting their clinical management and nutritional support.…”

Section: Discussionsupporting

confidence: 50%

Predictors of major lower limb amputation in children presenting to a single tertiary centre with perceived or true food allergies

Yusof

Rahman

Zulkifly

et al. 2015

smedj

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INTRODUCTION Diabetes mellitus (DM) is the most common cause of amputations in Malaysia. This study aimed to identify the predictive factors for major lower limb amputation among patients with type 2 DM (T2DM) who were admitted to a hospital, in order to reduce its likelihood. METHODSThis cross-sectional study involved 218 patients with T2DM who were admitted to Hospital Tengku Ampuan Afzan, Kuantan, Malaysia, for diabetic foot problems from June 2011 to July 2012. A form was developed to document the patients' profiles, comorbidities, complications, investigations, treatment and clinical outcomes. The predictors for major lower limb amputations were determined using univariate and stepwise logistic regression analysis. RESULTSA total of 31 patients underwent major lower limb amputations (25 transtibial, 6 transfemoral). The following factors were found to be associated with the incidence of major lower limb amputations: T2DM duration ≥ 10 years, diabetic neuropathy, diabetic nephropathy, presentation with gangrene, diabetic foot conditions of Wagner grade 4 or 5, and necrotising fasciitis. Patients who underwent major amputations had significantly lower haemoglobin and albumin levels, and higher total white blood cell counts, erythrocyte sedimentation rates, and C-reactive protein, urea and creatinine levels. However, only T2DM duration ≥ 10 years, positive bacterial culture and albumin levels were significant on stepwise logistic regression analysis.CONCLUSION T2DM duration ≥ 10 years, positive bacterial culture and low albumin levels were found to be significant predictive factors for major lower limb amputation among patients with T2DM admitted for diabetic foot problems.

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Section: Discussionsupporting

confidence: 50%

Predictors of major lower limb amputation in children presenting to a single tertiary centre with perceived or true food allergies

Yusof

Rahman

Zulkifly

et al. 2015

smedj

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show abstract

“…Hemoglobin levels of more than 10 g/dL and serum albumin of more than 25 g/L are important to ensure good post operative wound healing 10 .…”

Section: Discussionmentioning

confidence: 99%

Case Report and Surgical Technique: Closure with a Filleted Hallux Flap after Transphalengeal Amputation of the Big Toe for Osteomyelitis in the Diabetic Foot

K¹

2017

jmscr

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“…Criteria to have the Syme amputation include: ability to walk with a prosthesis following surgery, viable heel pad without infection, and enough vascular inflow to support wound estimated by ankle-brachial-indices > 0.5 in diabetics and 0.45 in non-diabetes [18][19]. A key component in quality outcomes after Syme amputation is a modification that attaches the heel pad to the distal tibia thus preventing migration and complicated prosthesis fitting [20]. Distal to the Syme amputation exist numerous options for treating forefoot and mid foot problems requiring amputation.…”

Section: Syme and Boydmentioning

confidence: 99%

“…The authors note the obvious possible flaw of those with a more distal amputation had less severe disease and thus were able to ambulate with more independence. Following Syme amputation, minimal gait training is required to return to ambulation, thus they are more likely to return to walking independence than the transtibial amputee [20]. Pinzur's study from 2003 revealed only 2/82 patients who had a Syme amputation were unable to ambulate with a prosthesis.…”

Section: Syme and Boydmentioning

confidence: 99%

A Surgeon’s Perspective on Lower Extremity Amputation and Rehabilitation

Donegan¹

2017

ORP

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Syme Ankle Disarticulation in Patients With Diabetes

Cited by 90 publications

References 8 publications

Predictors of major lower limb amputation in children presenting to a single tertiary centre with perceived or true food allergies

Predictors of major lower limb amputation in children presenting to a single tertiary centre with perceived or true food allergies

Case Report and Surgical Technique: Closure with a Filleted Hallux Flap after Transphalengeal Amputation of the Big Toe for Osteomyelitis in the Diabetic Foot

A Surgeon’s Perspective on Lower Extremity Amputation and Rehabilitation

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