1 of 3: Responses: Symes vs. Chopart
Monica Motloch
Description
Collection
Title:
1 of 3: Responses: Symes vs. Chopart
Creator:
Monica Motloch
Date:
7/24/2002
Text:
Thank you to everyone who responded: very helpful information. FYI: The family & orthopedic surgeon have chosen a Symes level amputation. The 15 responses are separated into three posts.
Question:
>I want to give as much info to the parents of a 9 yr old girl who
>is presently newly amputated at a Choparts level. She is
>scheduled for surgery on Tues. for a revision. I have run into
>some controversy with this on both sides of the fence, and if it
>comes down to personal experience, that's what I'm looking for!
>
>The parent are deciding to either stay at that level or move up
>to a Symes level.
>
>I'm seeking people's opinions, experience, advise and if there is
>any literature that might point to one level being more
>functional than another...Pro's and Con's, etc.
Answers:out of the 15 responses (posted below), 2 were pro-Chopart and 8+ were pro-Symes.
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1). A chopart is an appropriate level for a child if and only if two things have occurred in the past. 1. she has had the appropriate anterior musculature transfers and/or lengthening of the posterior musculature to balance the foot and 2. she has had a surgical or congenital bone growth arrest below the knee, allowing the large chopart distal end to be at the level of the largest part of the gastroc at the end of growth. Also it helps to have the calcaneous slid slightly posteriorly to aid suspension of the prosthesis.
-Gary M. Berke MS, CP,FAAOP
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2). Symes level is more preferable for a variety of reasons.
1. The amputation is easier to manage from a biomechanical standpoint-
Chaopart type amputations have a greater incidence of skin breakdown
2. Componentry is easier with a symes level- more foot options.
3. Length considerations for limb length are easier with a symes.
4. Cosmesis is better with a symes- easier to wear normal shoe and sneaker.
5. Suspension is better with symes than chopart.
Question:
>I want to give as much info to the parents of a 9 yr old girl who
>is presently newly amputated at a Choparts level. She is
>scheduled for surgery on Tues. for a revision. I have run into
>some controversy with this on both sides of the fence, and if it
>comes down to personal experience, that's what I'm looking for!
>
>The parent are deciding to either stay at that level or move up
>to a Symes level.
>
>I'm seeking people's opinions, experience, advise and if there is
>any literature that might point to one level being more
>functional than another...Pro's and Con's, etc.
Answers:out of the 15 responses (posted below), 2 were pro-Chopart and 8+ were pro-Symes.
-----------------------------------------------------------------------------------------
1). A chopart is an appropriate level for a child if and only if two things have occurred in the past. 1. she has had the appropriate anterior musculature transfers and/or lengthening of the posterior musculature to balance the foot and 2. she has had a surgical or congenital bone growth arrest below the knee, allowing the large chopart distal end to be at the level of the largest part of the gastroc at the end of growth. Also it helps to have the calcaneous slid slightly posteriorly to aid suspension of the prosthesis.
-Gary M. Berke MS, CP,FAAOP
---------------------------------------------------------------------------
2). Symes level is more preferable for a variety of reasons.
1. The amputation is easier to manage from a biomechanical standpoint-
Chaopart type amputations have a greater incidence of skin breakdown
2. Componentry is easier with a symes level- more foot options.
3. Length considerations for limb length are easier with a symes.
4. Cosmesis is better with a symes- easier to wear normal shoe and sneaker.
5. Suspension is better with symes than chopart.
Citation
Monica Motloch, “1 of 3: Responses: Symes vs. Chopart,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/219207.
