When upperclassmen and podiatry faculty recommended that I should read more classical clinical research papers in podiatric medicine and surgery as I prepare for 4th year and CASPR/CRIP, I noticed that all the classic foot and ankle surgeries and classic foot and ankle trauma classification names are from allopathic Foot and Ankle M.D. orthopods (ex: Cotton, Broca, Gustillo and Anderson, Wilson, Akin, Youngswick, Austin, Berndt and Hardy, Hawkins, Kudawa, to name a few). Is this classic historical orthopedic realm part of the reason why foot and ankle orthopods in some parts of America do not like podiatrists? Because of a turf war, in which podiatrists "trespassed" into the foot and ankle orthopod surgery and trauma realm? How much of the classical papers in podiatry are PURE orginals (in terms of theories/ideas/discoveries) by DPM podiatrists? I only can think of Dr. McGlamery and Dr. Root. Are there any other "classical" podiatrists who are legendary in podiatry from the past 100 to 150 years? Thank you.
Foot and Ankle Orthopods
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A number of the "classic" procedures and papers were created/written long before podiatry was routinely doing surgery and was more chiropody like. In those days few orthopedists did foot and ankle surgery regularly or exclusively. As podiatry evolved we were the ones who actually did the volumes of procedures that proved or disproved the success of the original ideas and research. Unfortunately our profession was not university based and studies and papers did not materialize. As we fought to gain hospital access some in the orthopedic community "borrowed" from our ideas and techniques and were touting their achievements. With the addition of fellowship training in orthopedics we are seeing more literature and true lower extremity orthopedists rather than generalist who do a foot once in awhile.
JFAS is a good journal and read worldwide. F&A Int also has value. I have arrived to a point where you are either a foot and ankle surgeon or not. Some good foot and ankle surgeons are MDs, some DOs, and some DPMs. We (podiatry) still treat the majority of patients who have foot and ankle problems and that IMO is what upsets some foot and ankle orthopedists.
BTW Austin was a DPM who became a DO when both degrees were considered inferior by many MDs. I'm sure that made the MDs happy and hence the chevron.
YES! Dr. Austin was a podiatrist! I wonder what podiatry school he graduated from? I am ASSUMING NYCPM, the oldest podiatry school in America. The Austin bunionectomy is so common and famous among the podiatry world, it is a relief and encouragement that such a famous name like Austin is a DPM! Nice! Things like the AO ORIF are MD European orthopods, which is what podiatrists follow for foot and ankle trauma surgery, bunionectomies, and reconstructive foot surgeries. But Austin as a DPM: that is good enough for me to love podiatry. Praise, AUSTIN!!!! I'm not worthy!
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Let's get a few things straight. I think it's important:
1) The "classical" foot and ankle orthopods you refer to weren't specially trained for foot and ankle. There were no F&A ortho fellowships back then. Some of those guys you mention just did a lot of foot cases, took special interest in it, published on it, etc. The idea of fellowship trained F&A orthos with very high training volume and high dedicated foot training time is relatively young (as is the idea of high volume/yrs of post-grad surgical training for DPMs).
2) Dale Austin is a DPM who later also acquired a MD degree (see 1981 Clin Ortho Rel Res ... incidentally, this inconvenient truth of Austin's DPM is likely why most MDs prefer to call the operation a "chevron" bunionectomy). Kuwada is a DPM... pretty good one too. He has literature on Achilles, plantar incision neuromas, etc. Run a search on pubmed, etc.
3) Of course it's a turf war... just like vasc vs interv cardio, interv radio vs anesth vs neuro, ortho spine vs neuro spine, plastic hand vs ortho hand vs gen hand, ENT vs plastics, ENT vs OMFS vs plastics, and tons of other turf battles due to scope of practice overlaps. At the end of the day, if you do good work, it generally won't go unrecognized by patients or other docs in your region.
GL, stay in school, and watch out: it looks like somebody might have taken a huge chip outta your shoulder?
1) The "classical" foot and ankle orthopods you refer to weren't specially trained for foot and ankle. There were no F&A ortho fellowships back then. Some of those guys you mention just did a lot of foot cases, took special interest in it, published on it, etc. The idea of fellowship trained F&A orthos with very high training volume and high dedicated foot training time is relatively young (as is the idea of high volume/yrs of post-grad surgical training for DPMs).
2) Dale Austin is a DPM who later also acquired a MD degree (see 1981 Clin Ortho Rel Res ... incidentally, this inconvenient truth of Austin's DPM is likely why most MDs prefer to call the operation a "chevron" bunionectomy). Kuwada is a DPM... pretty good one too. He has literature on Achilles, plantar incision neuromas, etc. Run a search on pubmed, etc.
3) Of course it's a turf war... just like vasc vs interv cardio, interv radio vs anesth vs neuro, ortho spine vs neuro spine, plastic hand vs ortho hand vs gen hand, ENT vs plastics, ENT vs OMFS vs plastics, and tons of other turf battles due to scope of practice overlaps. At the end of the day, if you do good work, it generally won't go unrecognized by patients or other docs in your region.
GL, stay in school, and watch out: it looks like somebody might have taken a huge chip outta your shoulder?
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Watch out, I KNOW where you live.As previously mentioned by Podfather, when most of the procedures you named were developed, podiatry was in it's infancy regarding surgery, and there really wasn't a foot & ankle orthopedic specialty.
Additionally, with the exception of the Weil osteotomy (named after Lowell Scott Weil, Sr., DPM) I don't know of any orthopods who routinely call any procedures they perform by any name that may be associated with a DPM, even if the DPM did create or modify the procedure. As Podfather has mentioned, most orthopods call the Austin the Chevron. Similarly, although some orthopods I know who have modified their distal osteotomies similar to a Kalish (Stanley Kalish, DPM) or a Vogler (Harold Vogler, DPM), they would never give kudos to the DPM.
I know many orthopedic surgeons who have performed endoscopic plantar fasciotomies, a procedure that was first described by Stephen Barrett, DPM.
And of course there is the NatCH method of procuring that special "cheese" from under the nail.......but that's another story.
