{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T05:33:18Z","timestamp":1777613598528,"version":"3.51.4"},"reference-count":63,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2018,1,10]],"date-time":"2018-01-10T00:00:00Z","timestamp":1515542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>In the decision-making process toward an amputation of the lower extremity, knowledge about patient-related outcomes after amputation and rehabilitation is important. We have not found a systematic review that provides this knowledge for Syme amputation. The aim of this study was to present an overview of outcomes after a Syme amputation grouped according to the International Classification of Functioning, Disability and Health (ICF) model, focusing on body structures and functions, activities, and participation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A systematic literature search was performed. Included studies went through 2 selection procedures by 2 independent assessors. Included were all studies concerning Syme amputation with patient-related outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Thirty-six studies were included for data extraction, concerning 1056 patients (238 children and 818 adults). Heel pad migration was reported in 49 of 176 (28%), skin problems in 23 of 128 (18%), and bone problems in 42 of 145 (29%) children. No reamputations were reported. All children were fitted with a prosthesis, and 62 of 90 (69%) children participated in sports. Skin problems were reported in 35 of 195 (18%), ulceration or infection in 120 of 512 (23%), residual limb pain in 46 of 181 (25%), and reamputations in 180 of 919 (20%) adults. In total, 247 of 363 (68%) adults were fitted with a prosthesis. Walking aids were used by 45 of 135 (33%) adults. Employment status was unchanged in 147 of 209 (72%) adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In children, no reamputations were necessary and few complications were reported, with good participation in daily life in the majority of children. In adults, more complications and reamputations were reported; nevertheless, most adult amputees became successful prosthesis users.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Therapeutic Level III, systematic review containing retrospective cohort studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1071100717745313","type":"journal-article","created":{"date-parts":[[2018,1,12]],"date-time":"2018-01-12T02:05:55Z","timestamp":1515722755000},"page":"284-291","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":22,"title":["Syme Amputation: A Systematic Review"],"prefix":"10.1177","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7787-9461","authenticated-orcid":false,"given":"Rudwina","family":"Braaksma","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, University of Groningen, University Medical Centre Groningen (UMCG), Groningen, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pieter U.","family":"Dijkstra","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, University of Groningen, University Medical Centre Groningen (UMCG), Groningen, the Netherlands"},{"name":"Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Centre Groningen (UMCG), Groningen, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan H. B.","family":"Geertzen","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, University of Groningen, University Medical Centre Groningen (UMCG), Groningen, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,1,10]]},"reference":[{"key":"bibr1-1071100717745313","unstructured":"2014.http:\/\/www.nhlbi.nih.gov\/health-pro\/guidelines\/in-develop\/cardiovascular-risk-reduction\/tools\/case_series"},{"key":"bibr2-1071100717745313","first-page":"415","volume":"28","author":"Alldredge RH","year":"1946","journal-title":"J Bone Joint Surg Am"},{"key":"bibr3-1071100717745313","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199512000-00012"},{"key":"bibr4-1071100717745313","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-198404050-00004"},{"issue":"3","key":"bibr5-1071100717745313","first-page":"124","volume":"100","author":"Azaria M","year":"1981","journal-title":"Harefuah"},{"key":"bibr6-1071100717745313","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.51B3.482"},{"key":"bibr7-1071100717745313","volume-title":"Amputation und Prothesenversorgung","author":"Baumgartner R","year":"1989"},{"key":"bibr8-1071100717745313","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2013.07.006"},{"key":"bibr9-1071100717745313","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199911000-00002"},{"key":"bibr10-1071100717745313","first-page":"459","volume-title":"Atlas of Amputations and Limb Deficiencies: Surgical, Prosthetic, and Rehabilitation Principles","author":"Bowker JH.","year":"2004","edition":"3"},{"key":"bibr11-1071100717745313","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199072090-00019"},{"key":"bibr12-1071100717745313","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197557070-00005"},{"key":"bibr13-1071100717745313","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-017-0433-7"},{"key":"bibr14-1071100717745313","first-page":"473","volume-title":"Atlas of Amputations and Limb Deficiencies: Surgical, Prosthetic, and Rehabilitation Principles","author":"Eckel TT","year":"2016","edition":"4"},{"key":"bibr15-1071100717745313","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197658080-00018"},{"key":"bibr16-1071100717745313","unstructured":"Elmslie RC. 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