No significant kinematic difference between Syme’s and transtibial amputations in children

ATLANTA —  There was little kinematic and gait difference for pediatric patients with a Syme’s amputation compared with a transtibial amputation, according to a study presented by Kelly A. Jeans, MS, Texas Scottish Rite Hospital for Children in Dallas, at the Association of Children’s Prosthetic-Orthotic Clinics Annual Meeting, here.

“It is often recommended to preserve limb length following amputation to maximize efficiency and symmetry of gait,” Jeans said. “So the purpose of this study was to determine if there are gait differences in children with a Syme’s amputation compared with children with a transtibial amputation and if residual tibial length and prosthetic foot type would contribute to this outcome.”

The study included 64 children with unilateral below-knee amputations: 41 with a Syme’s amputation and 23 with a transtibial amputation. Participants were categorized by high, medium or low activity level. The researchers used 3-D gait analysis, clinical assessment and the Pediatric Outcomes Data Collection Instrument (PODCI) to evaluate the patient’s gait and satisfaction with his or her prosthetic components.


Kelly A. Jeans


The researchers found that kinematic differences were less than 4° in total prosthetic ankle motion between the two groups. They also found no significant differences in knee kinematics, cadence parameters or PODCI scores.

“The current study shoes no kinematic difference at the knee and minimal gait differences between children with a Syme’s or transtibial amputation,” Jeans said. “However, despite improvement in ankle push-off power when using high-performance dynamic feet, this advantage was not reflected in the PODI sport/physical function or happiness score.”

For more information:

Jeans K. A Comparison of Syme’s and transtibial gait in children: factors that may play a role in outcome. Presented at: Association of Children’s Prosthetic-Orthotic Clinics Annual Meeting. April 10-13, 2013. Atlanta.

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