Retrospective cohort study of 97 diabetic patients undergoing Syme ankle disarticulation for neuropathic foot infection or gangrene over 11 years, evaluating whether this function-preserving amputation level can be safely performed in diabetics and which preoperative parameters predict wound-healing success.
When a diabetic patient presents with a nonsalvageable neuropathic foot infection, Syme disarticulation is a legitimate option — not a last resort — if ankle-brachial index is ≥0.5 (or TcPO₂ is 20–30 mmHg) and serum albumin has reached at least 2.5 g/dL after infection control; counsel smokers that their infection risk is three times higher, but wound-healing is not significantly compromised.
Retrospective cohort study of 97 diabetic patients undergoing Syme ankle disarticulation for neuropathic foot infection or gangrene over 11 years, evaluating whether this function-preserving amputation level can be safely performed in diabetics and which preoperative parameters predict wound-healing success.
When a diabetic patient presents with a nonsalvageable neuropathic foot infection, Syme disarticulation is a legitimate option — not a last resort — if ankle-brachial index is ≥0.5 (or TcPO₂ is 20–30 mmHg) and serum albumin has reached at least 2.5 g/dL after infection control; counsel smokers that their infection risk is three times higher, but wound-healing is not significantly compromised.