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03/02/2013    Lawrence Kobak, DPM, JD

Fixation Vs. Non-Fixation of Osteotomies (Gino Scartozzi, DPM)

I thought it was very interesting that one
podiatrist cited Dr. Mercado as an excellent
surgeon and example. Dr. Mercado has lectured
for the Academy of Ambulatory Foot Surgery and
in his excellent books, he has described several
minimal incision techniques that he himself
used! In the other letter published, somehow I
am taken to task about local vs. national
standards. I simply never wrote that. However,
as a healthcare attorney, I enjoyed the lecture
by someone with no legal training. The letters
are filled with conclusory "observations" and
war stories. Practices "market" themselves that
utilize all types of incisions and surgical

Additionally, there happens to be a breadth of
literature on non-fixated osteotomies, if the
writers would only look. One of the authors
appears to be overly worried about being able to
defend one's actions "on the stand." I would
advise the practitioner to be more concerned
about delivering the best care they can to their
patients. In court, scholarly articles are not
generally admissable in any case; they are here
say. I can assure your readers that there are no
shortage of competent, credentialed podiatric
and orthopedic experts that will testify in
favor of our practitioners concerning minimal
incision and non-internal fixation techniques
when appropriately used and performed.

I represent many laproscopic surgeons. The
arguments against them expressed by the "open"
surgeons seem to mirror what goes on in our
podiatric community. Let me end my comments on
this topic by repeating that we should learn to
respect each others' abilities and techniques.
We all can learn from each other. This has
always been an emotional subject, and it is time
we all realize that we have all advanced our
wonderful profession of podiatry.

Lawrence Kobak, DPM, JD, Manhasset, NY,

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Amfit temp