title: Achilles tendon tenodesis to prevent heel pad migration in the Syme's amputation.
abstract: In an attempt to prevent migration of the heel pad, 11 patients underwent a combined Syme's amputation and Achilles tendon tenodesis between December 1989 and April 1992. Ten patients healed the Syme's amputation, and one patient failed to heal the surgical wounds and required a below-knee amputation. In all 10 successful Syme's cases, the heel pad has remained stable with no migration, and no skin breakdown at an average follow-up of 18.5 months. Published series of Syme's amputations report that the incidence of heel pad migration is between 7.5% and 45%, and occurs primarily in the post-operative or early rehabilitation stage. We believe that tenodesis of the Achilles tendon is a technically easy addition to the Syme's amputation, that it keeps tension off of the incision during healing, and that it prevents migration of the heel pad.
authors.affiliation: University of Washington, Seattle 98102.
authors.forename: D G
authors.initials: DG
authors.lastname: Smith
authors.forename: B J
authors.initials: BJ
authors.lastname: Sangeorzan
authors.forename: S T
authors.initials: ST
authors.lastname: Hansen
authors.forename: E M
authors.initials: EM
authors.lastname: Burgess
mesh_terms: D000125:Achilles Tendon / Q000601:surgery*; D000671:Amputation, Surgical / Q000379:methods*; D005500:Follow-Up Studies; D005534:Foot Diseases / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D009985:Orthopedics / Q000379:methods; D016474:Weight-Bearing; D014945:Wound Healing