10/23/2024    David Secord, DPM

Physician or Allied Healthcare Provider? (Rod Tomczak, DPM, MD, EdD)

Although it pains me to say so, I agree with Dr.
Tomczak on the issue of research. In 2013, I
practiced in Riyadh, Saudi Arabia, at the King
Abdulaziz Medical City, Central Region hospital.
At that time, the Chief of the Section, Dr.
Abdulaziz al Gannass, was doing Charcot
reconstructions (as indicated) as ankle fusions,
either with or without talectomy. Instead of using
an intermedullary rod, he repurposed the Synthes
VA-LCP Condylar Plate (normally used to fixate
femoral fractures) to connect the tibia to the
calcaneus. The butterfly shape of the condylar
plate worked amazingly well at the calcaneus and
after removing the distal fibula, laying the plate
at the lateral aspect of the tibia to the
calcaneus made for a robust structure, as it is a
locking screw and plate system with variable angle
abilities. The majority of the patients walked on
it post-op (although informed that they were to be
non-weight-bearing) and none of these patient
failed to fuse.

In the case of a talectomy, allograft bone stock
was used to preserve limb length and integration
of graft took in every case. I wanted to start up
a research study concerning the Synthes VA-LCP
Condylar Plate as an alternative to the
intermedullary rod for fusions. With my own
background in research, I was willing to do all of
the work with the hospital’s IRB to get things
going. I needed help putting the numbers and
demographics together and tried to enlist the
other members of the team.

Dr. Gannass was obviously on board, but not a
single, solitary other soul wanted to be on board.
Just as these DPMs did no research in their
residency, so they had no thirst for expanding the
knowledge base within the profession. Without
help, I simply couldn’t do it on my own and the
project died. It was work. It didn’t increase
their salary. They didn’t care. Until this mindset
changes among the people in our profession and
those looking to join it, we are going to be held
back.

David Secord, DPM, McAllen, TX

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