An amputation at the ankle with removal of the malleoli and formation of a heel flap. Before this technique, the common surgical method for compound fractures of the tibia and fibula was to amputate at the thigh. The significant outcome of Syme's technique, in respect to prostheses, was that the patient had a foundation to walk on instead of cutting off the entire leg. The full length of the shank provided the typical weight bearing of a normal heel, with sensation and proprioception (the capability to sense where your leg is in space) that was not available before.
- J. Syme:
Amputation at the ankle-joint.
London and Edinburgh Monthly Journal of Medical Science, 1843, 3: 93-94.
The operation was first successfully performed by Syme on September 8, 1842. A modification of Syme's amputation, known as Mackenzie's operation, was introduced by the Scottish surgeon Richard James Mackenzie (1821-1854) six years later:
- R. J. Mackenzie:
On amputation at the ankle-joint by internal lateral flap.
Monthly Journal of Medical Science, Edinburgh, 1849, 9: 951-954.