Surgically successful Syme amputations have often been followed by use of less successful prostheses. A unique design for medial-opening Syme prostheses has been developed to address issues of comfort, flexibility, strength, lightness and durability. Parallel goals of reducing fabrication complexity, and therefore time, as well as providing ease of adjustment were also achieved.The design employs carbon graphite material in conjunction with a construction technique that is compatible with commonly used plastic fabrication methods. The procedure is designed to be readily adaptable to advances in materials technology. This article details the fabrication procedures for this medial-opening Syme prosthesis.