Syme and ankle disarticulation fitting is the intended application, where the residual limb reaches almost to the floor.
End-bearing residual limbs are characteristic of this level, with weight taken directly through the distal end.
Limb length matching is the governing requirement, since a foot too tall cannot be corrected by alignment.
Socket fabrication is affected by the attachment method, which should be established before the socket is built.
Cosmetic outcome is influenced by the bulbous distal shape of a Syme limb and how the foot sits beneath it.
Footwear selection is affected by heel height, which should be matched to the shoes the user wears.
Clinics fitting this level need the build height confirmed, since it is the constraint that decides suitability.



