Disarticulation has been carried out in ten ankles in nine patients in whom
it was not possible to use a heel flap, Four patients were able to walk wi
th a prosthesis which gave satisfactory function. In five who were bedridde
n, healing was achieved and was of sufficient quality to allow transfers. T
here was no operative morbidity or mortality.
This technique can be used instead of a transtibial amputation if necrosis
or ischaemia of the heel is a contraindication to conventional Syme's amput
ation.