An Air-Ventilated Syme's Leg Prosthesis
MICHAEL PEARL, C.P.O.,* AND RICHARD J. JOHNSON, M.D.**Saint Paul, Minnesota
Nair-ventilated Syme's leg prosthesis was designed to aid in eliminating the heat problem that bothers some patients with Syme's amputations. In addition to reducing heat disturbance, the new prosthesis is easier for the patient to apply and is cosmetically very acceptable.
Although the purpose of this paper is to present the prosthesis rather than to discuss surgery, most candidates for this prosthesis have paraxial hemimelias of the fibula with significant shortening and, in some cases, tibial bowing. The latter situation can be corrected or materially improved by tibial osteotomy. Drift of the heel pad has occurred in some cases but does not seem to present any real problems. As. a result of our experience with the case to be presented, we have fitted several patients with the new type of prosthesis (Figs. 1 and 2 ). We have been uniformly pleased with the results, and since 1978 have been fitting almost all of our Syme's amputees with the type of prosthesis described here.
The patient is a female born on February 3, 1964. A Syme's type of amputation was performed on January 20, 1976 and tibial osteotomy of March 20 of the same year at Gillette Children's Hospital. A Syme's-type leg prosthesis with a removable PE-LITE soft socket insert and a SACH foot-ankle assembly was fitted on June 10, 1976. The patient adapted easily to the prosthesis, and walked well. After one month she was seen in the prosthetic clinic with a considerable heat problem evident. The skin on her amputation limb showed signs of irritation. The problem was partially solved by perforating the socket and liner. She was very conscious about her appearance and disliked the perforated prosthesis. This compelled us to look for a different solution to the problem. On May 26 we fitted her with an air-ventilated socket prosthesis of the new design. She has worn the prosthesis continuously with good results. Some advantages of the prosthesis are the elimination of the heat problem, ease of application and improved appearance. Since 1978 almost all Syme's amputees have been fitted with the ventilated inner socket prosthesis as a routine procedure.
*Gillette Children's Hospital, 200 East University Avenue, Saint Paul, MN 55101 "Capital Orthopaedics, Ltd., 590 Park Street, Saint Paul, MN 55103