Revision of Symes (fibular hemimelia) to a TT

Revision of Symes (fibular hemimelia) to a TT

DeAnna Chapman

3/2/2016

I have a 22 y/o male patient who has fibular hemimelia and has had a symes amputation since he was 6 months old. He is a new patient who presented for a consultation after speaking with his surgeon about having a revision surgery to amputate the distal end of his tibia to result in a transtibial amputation. He has had chronic distal end pain, wounds and the heel fat pad has migrated posteriorly resulting in a very bony distal end. His tibia has anterior bowing that often happens with fibular hemimelia, so the physician and patient are questioning at what level to amputate.

Has anyone had a patient go through a revision surgery from a symes to a transtibial level? Specifically one with fibular hemimelia? If so, at what level did they amputate the tibia? What concerns does this patient and surgeon need to be aware of?

Thank you in advance,
DeAnna Chapman, CPO, LPO, FAAOP
Gainesville Prosthetics