Syme amputation. An evaluation of the physical and psychological function in young patients.

Twenty-one patients who had had twenty-three Syme amputations at an average age of four years and eleven months were studied to assess their physical and psychological functional status. Physical evaluation was based on a timed fifty-yard (45.7-meter) dash, Cybex testing of quadriceps and hamstring function, and history of sports participation. Psychological function was based on four psychological tests. Quadriceps power correlated closely with athletic function. Excessive genu valgum caused a noticeable abnormality of gait. Migration of the heel pad did not cause problems with gait. Better psychological function correlated with better orthopaedic function. The level of family stress was the predominant factor that influenced test results relative to behavior, self-concept, and intelligence quotient. As a result of this study, we believe that a Syme amputation in a young patient may be compatible with athletic and psychological function closely approaching that of a non-handicapped child of the same age.