Syme amputation of toenail Syme amputation of toenail. A: Elliptical or rectangular incision is centered over the nail bed and matrix. B: The distal half of the distal phalanx is resected. C: Excess skin is resected, and skin edges are approximated. (Reproduced, with permission, from Mann RA, Coughlin MJ: The Video Textbook of Foot and Ankle Surgery. Medical Video Productions, 1991.) Source: Chapter 8. Foot and Ankle Surgery, Current Diagnosis & Treatment in Orthopedics, 5e Citation: Skinner HB, McMahon PJ. Current Diagnosis & Treatment in Orthopedics, 5e; 2014 Available at: http://accesssurgery.mhmedical.com/DownloadImage.aspx?image=/data/books/skin5/skin5_c008f030.png&sec=45456056&BookID=675&ChapterSecID=45451714&imagename= Accessed: October 21, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved