Question about the limits of podiatric surgery

[McGG55]

I'm considering Podiatry as a career and I think I would definitely enjoy becoming a podiatric surgeon. I am curious about one thing however and I cannot seem to find a good answer for this anywhere. Obviously a podiatric surgeon can work on the foot and ankle, but to what extent can they perform surgery on parts proximal to the foot and ankle? Can a podiatrist perform surgery on the tibia and fibia? Could they even perform surgery on the patella or amputate structures as high up as the knee? I know state laws have significant impact on what a podiatrist can and cannot do, but some states are a lot less clear about their restrictions than others.

One last question, a few states allow podiatrists to perform work on the hands. Why is this allowed or what was the reasoning behind this? Was it primarily due to a lack of sufficient healthcare providers? I don't see why a podiatrist would be qualified to work on the hand.

Thanks in advance!

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[DexterMorganSK]

I'm considering Podiatry as a career and I think I would definitely enjoy becoming a podiatric surgeon. I am curious about one thing however and I cannot seem to find a good answer for this anywhere. Obviously a podiatric surgeon can work on the foot and ankle, but to what extent can they perform surgery on parts proximal to the foot and ankle? Can a podiatrist perform surgery on the tibia and fibia? Could they even perform surgery on the patella or amputate structures as high up as the knee? I know state laws have significant impact on what a podiatrist can and cannot do, but some states are a lot less clear about their restrictions than others.

One last question, a few states allow podiatrists to perform work on the hands. Why is this allowed or what was the reasoning behind this? Was it primarily due to a lack of sufficient healthcare providers? I don't see why a podiatrist would be qualified to work on the hand.

Thanks in advance!

Hopefully, a DPM can answer your questions specifically, but most of your answers can be found on a State's website for the scope of practice since it varies all over the US.

So, for example, if you wanted to see the scope of practice in NY you would go here: NYS Podiatry
and click to those tabs on the left to get your answers. Same goes for other states.

Imo, the hand stuff has to do with the similarities between the upper and lower limb anatomy, need for care in underserved communities but even then these privileges are usually limited and extra training is probably required. For example, in the state of Ohio, a Pod can do a lot of cool stuff on the hand, check the scope of practice:

OHFAMA | DPM Scope of Practice

Vested in your success as podiatric physicians and surgeons. Ohio’s champions for quality foot and ankle medical care for our members and we proudly keep Ohioans on their feet. Member support today, so that they are prepared for tomorrow’s podiatric medical practice issues. The “go to”...

www.ohfama.org

Scope of practice from the ACFAS can be found here (not sure how recent this is):

https://www.acfas.org/uploadedFiles/Physicians/Health_Policy_and_Advocacy/Scope_of_Practice/Content/State Scope of Practice.pdf

 

[ldsrmdude]

I'm considering Podiatry as a career and I think I would definitely enjoy becoming a podiatric surgeon. I am curious about one thing however and I cannot seem to find a good answer for this anywhere. Obviously a podiatric surgeon can work on the foot and ankle, but to what extent can they perform surgery on parts proximal to the foot and ankle? Can a podiatrist perform surgery on the tibia and fibia? Could they even perform surgery on the patella or amputate structures as high up as the knee? I know state laws have significant impact on what a podiatrist can and cannot do, but some states are a lot less clear about their restrictions than others.

One last question, a few states allow podiatrists to perform work on the hands. Why is this allowed or what was the reasoning behind this? Was it primarily due to a lack of sufficient healthcare providers? I don't see why a podiatrist would be qualified to work on the hand.

Thanks in advance!

Like @DexterMorganSK said, a lot depends on the state scope of practice, but I doubt any podiatrist in a normal practice is doing patella/knee work or doing amputations proximal to the ankle. There may be a few exceptions, but they would definitely be very rare. As far as the tibia and fibula, sure, we do surgery on the distal portions of the tibia and fibula. Ankle fractures, pilon fractures, ankle fusions or replacements, etc are all things you would see a podiatrist doing. We will also do work in the mid tibia or fibula when it involves the ankle, such as putting in an intramedullary nail for a TTC fusion, applying an external fixator, or even harvest bone graft from the proximal tibia in some cases. In general, we operate on the distal portions of the tibia and fibula when it comes to bone. Many states allow soft tissue work to the lower leg, or even to the hip, so a podiatrist could repair a ruptured Achilles, treat a venous leg ulcer, do a proximal gastrocnemius release, etc.
As far as states allowing hands, it is usually an old law on the books that was from when podiatrists were still called chiropodists (and historically treated hands) and usually only includes soft tissue things such as trimming fingernails, treating warts, etc. I did my residency in a state where the hand is included in the scope of practice and nobody does anything with the hand, except maybe trim a patients fingernails in rare cases, or tell a patient to put acid on a wart on their finger. I don't think any of the laws allowing podiatrists to treat hands are new, I think they're all old.