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SYME LEVEL VERSUS CHOPART LEVEL IN WAR SURGERY

7th Congress of the European Federation of National Associations of Orthopaedics and Traumatology, Lisbon - 4-7 June, 2005



Abstract

Introduction: Within the period from 1992. to 1996. (War in Bosnia) we performed 528 amputations. At the Chopart level in 45 (8.5%) patients and at the Syme level by 7 (1.3%) patients.

Etiology: In more than 90 % patients the injury was caused by mine.

Method: Open method, primary suture or primary delayed suture. We had 6 reamput actions and 15 corrections.

Result: The Chopart stump inclines to deformation (we can often use only a part of calcaneus and talus). Achille’s tendon pulls the heel in increased supination and this is disturbing when leaning onto it and when placing the prosthesis. We achieved good results with the Baumgartner procedure: lengthening of Achille’s tendon, transfer of tendon m. tibialis anterior and tibio=tal=calcaneal arthrodesis. In cases with infection or if there remains only half of the calcaneus and talus, we prefer Syme level.

Conclusion: The patient with CH stump was properly followed and kept under control. We prefer Baumgartner procedure as prevention of deformation. In some cases the better result are achieved with the Syme level (it remains only part of calcaneus and talus)

Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.