A Primer on Orthoplastics in Podiatric Practice

I'm Raymond Lee. I am a podiatrist practicing out of Union, New Jersey. I graduated from the New York College of Podiatric Medicine and then afterwards I completed a three-year residency at the Morristown Memorial Medical Center in Morristown, New Jersey. I am now an active faculty member at the Morristown Residency Program.

Orthoplastics is basically a multidisciplinary surgical approach. Basically it encompasses plastics techniques for management of soft tissue as well as orthopedic techniques for management of osseous issues. And so basically, it's an integrated type of surgical approach to be utilized for more complex types of cases. I think it's really useful for podiatry specifically because I feel like podiatry is one of the very few professions that at the very beginning we already start getting taught on both plastics techniques and orthopedic techniques. We have such an astounding understanding of the biomechanics of the lower extremities and using our orthopedic techniques, we can correct these biomechanical issues while at the same time using plastic techniques we can resolve any type of soft tissue envelopes that we would be concerned about.

I'm in private practice, but I also work in a wound care center, and so a lot, I would say probably about a good 40% of my patient population presents with some type of wounds. Unfortunately, some of these patients, they've already had wounds that has been there for a while, very prolonged chronicity, and they've tried a lot of different types of advanced treatments with failure to resolve. And so for me, I utilize different types of flaps, whether it be cutaneous, fasciocutaneous, adipofascial muscles to try to cover up some of these deficits. But at the same time, I'm also, again, reevaluating these patients from a biomechanical standpoint and using orthopedic techniques to resolve these biomechanical issues, whether it be using external fixation or doing reconstructive care, some form of nature.

I think that orthoplastics, it's been around for a while, but I feel like now it has become much more on the rise in terms of just the overall exposure of it, and so I definitely would like our younger students and younger residents to come in with that open mind to adapt to some of these techniques. And I was very fortunate about the Morristown program that I had a lot of faculty to teach me, whether it be podiatry or non-podiatry faculty, they were just very willing to teach. And so I would definitely implore everybody that is interested in this to really just reach out to those resources and try to learn as much as possible.

For me, myself, I used the Plastics Atlas a lot. I thought McCarthy's textbook was fantastic, and that was really kind of the entry for me to start learning a little bit about these principles. The wonderful, wonderful thing about podiatry is that everybody is just so easily accessible. Everybody in our profession is very willing to teach. For today's conference, for example, I met doctors who are always been very willing to go over cases with you and discuss with you. But it's also with, I think the medical profession in general everybody is just very willing to kind of, hey, okay, you have a question about this. This is how I would approach it, and so I think that's a pretty interesting thing.