Syme's ankle disarticulation: the transmalleolar amputation.

Salvage of the infected extremity in diabetic patients continues to be a complex problem. Amputation at the Syme's level helps maintain patient independence and decreases the rehabilitation expense associated with more proximal amputation. Although the wound complication rates are relatively high, the ultimate healing rate and favorable functional outcomes in this high risk patient population make this an outstanding amputation level for pedal amputation.