ORTHOPEDIC PHYSICIAN OR A PODIATRIST?
Often, patients are not clear about whether they should see an orthopedic surgeon or a podiatrist for their foot and ankle problems. Here are some things to consider.
There are many different types of healthcare providers that evaluate and treat conditions of the feet. These include orthopedic surgeons, podiatrists, primary care physicians, and physical therapists. While orthopedic surgeons and podiatrists have different training, they often work together to treat many of the same conditions.
An orthopedic surgeon is a medical doctor (who is an M.D. (Doctor of Medicine) or a D.O. (Doctor of Osteopathic Medicine). They are trained to treat the entire musculoskeletal system, not just one extremity. Orthopedics is the diagnosis, treatment, rehabilitation, and prevention of injuries and diseases in your musculoskeletal system. Many orthopedic physicians specialize in the treatment of the foot and ankle. All Florida Orthopaedic Institute foot and ankle physicians are fellowship trained in this specialty.
All foot and ankle surgeons at Florida Orthopaedic Institute have the following formal education:
- Four years of undergraduate school
- Four years at an accredited medical school
- Five years of generalized orthopedic surgical residency training
- Additional fellowship training dedicated to treatment of foot and ankle disorders
The foot and ankle physicians at Florida Orthopaedic Institute have a philosophy to try all appropriate nonsurgical methods first to increase mobility and function. This can include medication, shoe modifications, bracing, injections, and physical therapy. Florida Orthopaedic Institute provides all these services. If efforts are unsuccessful, then, and only then, do they suggest surgery.
When surgery is indicated, the operative experience of the surgeon is critical. With the largest combined experience in Florida, the Florida Orthopaedic Institute team has performed tens of thousands of these procedures, including flat foot corrections, ankle and subtalar fusions, midfoot osteotomies, bunion surgery, total ankle replacements, soft tissue reconstructions as well as fracture reconstruction.
A podiatrist is a Doctor of Podiatric Medicine (DPM) with specialized training to treat foot and ankle disorders. Typically, they have the following formal education:
- Four years of undergraduate school
- Four years at an accredited podiatric medical school, where they receive medical training plus specialized training on the foot, ankle, and lower leg
- Three to four years of foot and ankle residency training
A podiatrist treats the foot, ankle, and connecting parts of the leg.
Podiatrists are certified by the American Board of Podiatric Medicine. Some podiatrists may also complete more specialized fellowship training that focuses on a specific area. Podiatrists who specialize in foot surgery are called podiatric surgeons. A podiatric surgeon must pass special exams in general foot health and surgery for foot conditions and injuries before being certified by the American Board of Foot and Ankle Surgery.
The podiatrists at Florida Orthopaedic Institute treat conditions of the lower extremity below the knee that include all nonsurgical modalities. This can include medication, shoe modifications, custom orthotics, custom bracing, injections, and physical therapy. Florida Orthopaedic Institute provides all these services. If efforts are unsuccessful, then, a referral to one of our highly trained orthopedists is warranted for surgical consult.
WHEN TO SEE AN ORTHOPEDIST OR A PODIATRIST?
At Florida Orthopaedic Institute, we are proud to have both highly trained orthopedic surgeons and podiatrists who work together to provide the most comprehensive care. Our doctors provide a full scope of surgical and non-surgical treatment options with the goal to relieve pain and allow the return to a high level of function as quickly as possible.
Florida Orthopedic Institute surgeons are leaders in the field with over 20 years of experience, performing thousands of ankle fusions, triple arthrodeses, subtalar fusions, and over 300 total ankle replacements. Since 1989, Florida Orthopaedic Institute surgeons have helped thousands of patients get back on their feet with Tampa Bay’s most advanced orthopedic foot and ankle treatment center. Knowledgeable and experienced physicians, therapists, and nurses work in concert to cover the total spectrum of foot and ankle musculoskeletal care. Whether tendon, ligament, bone injuries, arthritis, or acute/chronic conditions, surgeons are fellowship trained and have extensive knowledge in managing all conditions affecting the foot, ankle, and lower leg.
The foot and ankle surgeons at Florida Orthopaedic Institute are well-respected fracture specialists, managing the most complex of these problems with a national and international reputation. Many of the devices used to treat these injuries (plates, screws, and intramedullary nails) were developed by members of the team. This expertise is unique in the region and allows for managing problems with predictable outcomes and teaching others through courses, lectures, and publications.
Ankle arthritis is a relatively common problem that requires careful management to maintain motion while minimizing pain. The first line of treatment remains oral medications, but the staff frequently uses stem cell injections to reduce the inflammation within the ankle that causes the pain. When this is not effective, arthroscopy may be used to remove irritating tissue.
These minimally invasive procedures are designed to prevent the need for an open procedure. But when arthritic pain and deformity prevents patients from maintaining a normal lifestyle, either a fusion or an ankle replacement is required.
Our podiatrists see any nonsurgical conditions of the lower extremity below the knee and perform any in office procedures. This includes the following:
- Generalized foot, ankle, or calf pain
- Lower extremity edema and numbness
- Hammertoes and bunions requiring conservative management
- Digital fractures of the foot
- Ankle sprain or tendinitis
- Heel pain: Achilles tendinitis and plantar fasciitis
- Soft tissue masses: fibromas, ganglion cysts, lipomas
- Wound care: trauma, diabetic pressure ulcers, delayed healing incisions
- Toenail deformities and ailments: fungus, ingrown toenails, and suspicious discoloration
- Dermatological conditions: warts, tinea, suspicious lesions requiring biopsy
- Custom orthotics and bracing
Wounds can develop for a multitude of reasons including but not limited to trauma, pressure, vascular insufficiency, post-surgical complications, burns, and neuropathy. Early wound care helps prevent serious infection often in patients with underlying health conditions delaying the healing process. Wound care includes diagnosis of wound type, assessing factors that affect patients’ wound healing, and determining proper treatment. Some of the many factors that can impact wound healing include malnutrition, arterial disease, poor tissue oxygenation, tobacco use, diabetes, and obesity. In addition to tailoring the correct treatment plan, our highly trained podiatrists use a host of wound care products and biologics to quickly heal wounds; frequent and adequate debridement is a vital component to the healing. Prevention and monitoring are also important in preventing at risk patients from developing ulcerations.
TOTAL ANKLE REPLACEMENT
In 1995, the Agility® total ankle prosthesis became available in the U.S. with Florida Orthopaedic Institute surgeons involved in designing, teaching, and evaluating the implant. Later that year, a European ankle known as the S.T.A.R.® was released, and again Florida Orthopaedic Institute surgeons were involved in the first trial of that prosthesis in the U.S.
Since then, FOI surgeons (all trained on total ankle replacements) have performed hundreds of replacements. With over 20 years of experience, the foot and ankle surgeons of Florida Orthopaedic Institute remain leaders in the field.
For those patients that are not candidates for an ankle replacement, ankle fusions remain the gold standard. Patients can walk without a limp using modern techniques to remove minimal amounts of bone and position the ankle, so the joint below moves well.
REVISIONS & REFERRALS
Because of the combined expertise of the podiatric physicians and nationally recognized foot and ankle surgeons, patients are referred not only locally but from all over the country. Many of the referrals are patients with significant post-surgical complications, including infections, failed joint replacements, poorly positioned fusions, and non-healed fractures. These patients are sent to Florida Orthopaedic Institute for definitive solutions to their problems, and in most cases, the Florida Orthopaedic surgeons can improve their lives. This ability to solve complex problems and help patients is the driving force behind maintaining the high quality of care offered and is why Florida Orthopaedic Institute is a regional and national referral center.
Specialties include the treatment of:
- Achilles Tendon Injuries
- Chronic Ankle Ligament Injuries
- Adult Acquired Flatfoot
- Bunion Surgery
- Hammer Toe
- Morton’s Neuroma
- Stem Cell Injections
- Arthritis of the Foot and Ankle
- Fractures of the Foot and Ankle
- Total Ankle Arthroplasty (Ankle Replacement)