[The birth of modern surgery].

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Abstract

[Indexed for MEDLINE] 14. Foot Ankle Int. 1994 Jan;15(1):14-7. doi: 10.1177/107110079401500104. Achilles tendon tenodesis to prevent heel pad migration in the Syme's amputation. Smith DG(1), Sangeorzan BJ, Hansen ST Jr, Burgess EM. Author information: (1)University of Washington, Seattle 98102. In an attempt to prevent migration of the heel pad, 11 patients underwent a combined Syme's amputation and Achilles tendon tenodesis between December 1989 and April 1992. Ten patients healed the Syme's amputation, and one patient failed to heal the surgical wounds and required a below-knee amputation. In all 10 successful Syme's cases, the heel pad has remained stable with no migration, and no skin breakdown at an average follow-up of 18.5 months. Published series of Syme's amputations report that the incidence of heel pad migration is between 7.5% and 45%, and occurs primarily in the post-operative or early rehabilitation stage. We believe that tenodesis of the Achilles tendon is a technically easy addition to the Syme's amputation, that it keeps tension off of the incision during healing, and that it prevents migration of the heel pad. DOI: 10.1177/107110079401500104