Congenital Defect Surgery?

[doclm]

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How often does a POD do surgery for congenital defects with feet/lower leg?

Just last week, I came across a prenatal baby with some serious congenital defects, which included a prolonged Tibia which was not intact with the Talus. I asked the nurse what they are planning to do about this and he said that Ortho will probably splint the foot/ankle and possibly do corrective surgery. Keep in mind that this medical institute, no DPM's do any surgery here, only the 3 DPM's do comprehensive foot care.

However, does a DPM usually at a different medical center, take care of congenital defects with feet? Have any of you done reconstructive foot surgery to repair a congenital defect? Club foot?

Thanks for your input.

 

[jonwill]

I've assisted with the Ponsetti casting method for Talipes Equinovarus on several occasions. A lot of times, the child also needs a tendo-achilles lengthening. A lot of doctors (pods included) don't feel comfortable doing surgery on an infant. The podiatrist with training in podopediatrics is qualified to do this.
Side note: Dr. Ponsetti, an orthopedic surgeon at the U of Iowa, still practices and I actually heard him speak last year at a podiatry conference. He has worked with several podiatrists in Iowa on clubfoot cases.

 

[krabmas]

we did a lengthening procedure for brachymetatarsia on a 16 year old. we had to wait until they stopped growing. we put in a bone graft from the 2nd met into the 4th.

the 4th started out shorter and the 2nd long.

there have been some ponsetti methods done and some other congenital deformities fixed but I have not been in the OR for them. 😡

 

[doclm]

I've assisted with the Ponsetti casting method for Talipes Equinovarus on several occasions. A lot of times, the child also needs a tendo-achilles lengthening. A lot of doctors (pods included) don't feel comfortable doing surgery on an infant. The podiatrist with training in podopediatrics is qualified to do this.
Side note: Dr. Ponsetti, an orthopedic surgeon at the U of Iowa, still practices and I actually heard him speak last year at a podiatry conference. He has worked with several podiatrists in Iowa on clubfoot cases.

Thanks for the reply,

I am glad to hear that Podiatrists do play a part in surgically reconstructing feet, besides Orthopods. Not seeing any PODS in the OR where I work has worried me in the past, because I am not quite sure how and where they do surgeries. But by the sounds of you guys down in Iowa, PODS get a good surgical training. However, that is not what I want to focus everything on either. I understand that Podiatrists probably end up doing actual surgery 20% of their time if not less because the career involves total comprehensive foot care as well.

 

[jonwill]

Thanks for the reply,

I am glad to hear that Podiatrists do play a part in surgically reconstructing feet, besides Orthopods. Not seeing any PODS in the OR where I work has worried me in the past, because I am not quite sure how and where they do surgeries. But by the sounds of you guys down in Iowa, PODS get a good surgical training. However, that is not what I want to focus everything on either. I understand that Podiatrists probably end up doing actual surgery 20% of their time if not less because the career involves total comprehensive foot care as well.

There are two very good surgical residency programs in the Minneapolis area:

-Hennepin County Medical Center
-Health Partners/Regions Hospital

 

[JohnfootDr]

One reason Pods don't do as much pediatric surgery is that there really isn't much of a comprehensive training program in any residency on Peds. If you work with an orthopod who does a lot of Peds, then you get your training, but some residencies don't have that.

Another issue is Malpractice on peds. In many states, the statute of limitations on filing lawsuits is about 5 years (some more, some less). However, if you do surgery on a peds patient, that statute then becomes 5 years + the length of time until the patient becomes 21. So, if you do surgery to correct clubfoot (TEV) on a 1 year old, and when the patient can't wear her wedding shoes she has dreamed of all her life because of your surgery 24 years prior, she can still sue you. Kind of a pain.