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Foot and Ankle Reconstruction About the rotation The foot reconstruction rotation offers an excellent experience under the supervision of fellowship-trained faculty. This fourth year rotation is based at the University of Washington Medical Center and Harborview Medical Center. Mondays are spent with Nancy Kadel, M.D. in the operating room at the University of Washington Medical Center. Tuesday through Friday are spent with Sig T. Hansen, M.D.; Bruce Sangeorzan, M.D. and Steve Benirschke, M.D. at Harborview Medical Center. During this rotation emphasis is placed on the comprehensive evaluation of patients with degenerative, inflammatory and post traumatic conditions of the foot and ankle. Goals & objectives Our goals are to teach the essentials of foot and ankle reconstruction relevant to a general orthopaedic practice. During this rotation, residents learn to perform a thorough assessment and management plan for individuals with foot and ankle conditions. This will often include consideration of systemic factors such as age, immune compromise, rheumatoid arthritis, urinary tract problems, and potential for pulmonary, cardiac and coagulopathic problems and Diabetes Mellitus. Residents learn preoperative planning of primary and revision ankle arthodesis, arthroplasty, and re-alignment procedures for malunion and acquired foot deformity. Residents read actively during this rotation. There is a reading list that is updated by regular review of the current literature and primary textbooks. In the clinic, residents learn the principles of evaluation of the foot and ankle, including the history, physical exam, radiography and ancillary tests. This experience provides a context for understanding the natural history of OA, RA, Post traumatic AVN, sepsis, fractures, and charcot joints associated with Diabetes Mellitus. The evaluation of soft tissue imbalance is paramount to this service. On the inpatient service the residents learn the details of caring for patients after surgical procedures. This includes DVT prophylaxis, pain management, physical therapy and discharge planning. In the operating room the residents learn the surgical approaches to the foot and ankle and become facile with those procedures that are performed routinely by a general orthopaedist. |
