Bone elngation surgery

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bunion123

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I was recently watching the show Doctors, and Dr. Alireza Khorsoabadi did an elongation of the 4th metatarsal. I looked him up and saw he went to NYCPM 👍 did his residency as part of the clinic and did a fellowship at The International Center for Limb Lengthening (ICLL) at Sinai Hospital of Baltimore.
Anyway.. I found the whole bone elongation procedure and technique quite fascinating. Are there other programs that teach how to do this?
Is it something you would at least see in most residency programs?
Any ideas of things I can start doing from now...(only in my 10th week of school) to show I have an interest in this field?

Would appreciate any responses
Thank You
 
bunion123 said:
I was recently watching the show Doctors, and Dr. Alireza Khorsoabadi did an elongation of the 4th metatarsal. I looked him up and saw he went to NYCPM 👍 did his residency as part of the clinic and did a fellowship at The International Center for Limb Lengthening (ICLL) at Sinai Hospital of Baltimore.
Anyway.. I found the whole bone elongation procedure and technique quite fascinating. Are there other programs that teach how to do this?
Is it something you would at least see in most residency programs?
Any ideas of things I can start doing from now...(only in my 10th week of school) to show I have an interest in this field?

Would appreciate any responses
Thank You
Click to expand...

This doctor does cosmetic limb lengthening, hmmm...
 
arez,

It absolutely can be purely cosmetic.

ferocity,

what was the point of that link? We know he does cosmetic limb lengthening, but that doesn't make everything he does cosmetic. Brachymetatarsia surgery isn't always a cosmetic procedure.

There is a segment on a local news channel where he lengthens the limb of a patient who suffered a traumatic injury during a MVA. Patient developed an abnormal gait and serious functional limitations when ambulating, causing pain and a noticeable decrease in her qol. I don't know how you would call that cosmetic

I'm more curious to know wether part II used to be offered in December....
 
dtrack22 said:
arez,

It absolutely can be purely cosmetic.

ferocity,

what was the point of that link? We know he does cosmetic limb lengthening, but that doesn't make everything he does cosmetic. Brachymetatarsia surgery isn't always a cosmetic procedure.

There is a segment on a local news channel where he lengthens the limb of a patient who suffered a traumatic injury during a MVA. Patient developed an abnormal gait and serious functional limitations when ambulating, causing pain and a noticeable decrease in her qol. I don't know how you would call that cosmetic

I'm more curious to know wether part II used to be offered in December....
Click to expand...

Too many assumptions.

All I said was this doc performs cosmetic limb lengthening. Ask the docs here how they feel about that...
 
Wait, who's making too many assumptions?

It is not an assumption that any bone lengthening procedure can be considered something other than cosmetic. Unless, of course, you would like to describe to me other treatment options for a brachymetatarsia patient who complains of chronic pain and has developed multiple hyperkeratotic and ulcerative lesions plantar to the non-affected met heads, where conservative options have failed.

I agree with with most of what the attendings have posted regarding "cosmetic" procedures. But the term "cosmetic" has to be defined before that discussion can take place. Simply fixing a deformity may or may not be cosmetic, meaning you can't lump all bunion procedures, arthroplasties, etc into a "cosmetic" category. I still don't understand why you posted the link in response to arez's post, it didn't prove some point if that's what you were going for.
 
dtrack22 said:
Wait, who's making too many assumptions?

It is not an assumption that any bone lengthening procedure can be considered something other than cosmetic. Unless, of course, you would like to describe to me other treatment options for a brachymetatarsia patient who complains of chronic pain and has developed multiple hyperkeratotic and ulcerative lesions plantar to the non-affected met heads, where conservative options have failed.

I agree with with most of what the attendings have posted regarding "cosmetic" procedures. But the term "cosmetic" has to be defined before that discussion can take place. Simply fixing a deformity may or may not be cosmetic, meaning you can't lump all bunion procedures, arthroplasties, etc into a "cosmetic" category. I still don't understand why you posted the link in response to arez's post, it didn't prove some point if that's what you were going for.
Click to expand...

What are you going on about? I didn't say ANYTHING about the patient, or lump cosmetic procedures with anything else.

Again, since you're having a difficult time comprehending this: All I said was that this doctor performs cosmetic limb lengthening.
 
Can we get the post back to topic maybe?
Is bone lengthening something one would expect to see and have a chance getting trained in in podiatric residency. What kind of certification would be needed?
 
bunion123 said:
Can we get the post back to topic maybe?
Is bone lengthening something one would expect to see and have a chance getting trained in in podiatric residency. What kind of certification would be needed?
Click to expand...

Definitely seems like an interesting niche to super specialize in, thanks for bringing up this topic. 👍

Here's a fellowship open to DPMs: http://www.lifebridgehealth.org/RIAO/LimbReconstructionFellowshipProgram.aspx

And the ortho group where only one of the docs does cosmetic limb lengthening, and has the decency to advise not doing this procedure for cosmetic reasons. Here

Here's the DPM in that ortho group (he's not the one that does cosmetic limb lengthening), he did the fellowship mentioned above:
http://www.lifebridgehealth.org/RIAO/AboutDrBradleyMLamm.aspx
 
Unless I'm reading something incorrectly, the fellowship(s) currently being offered seem to require a medical degree, not DPM degree.

This is a very specialized and finite field, and you can probably count on one hand or less, the number of DPMs who have a practice dedicated to this specialty. The majority of these lengthenings are of the leg, and are performed by orthopedic surgeons. Even with proper training and skills, a DPM performing limb lengthening (leg, not foot) is treading on dangerous turf. The doctor in the article amd on Dr. Oz practices with an orthopedic surgeon, so we don't know his role during a leg limb lengthening.

George Vito DPM did have a practice pretty much dedicated to this specialty. Google his name and you will come across the details of the lawsuit that ended his career and ruined him financially.
 
PADPM said:
George Vito DPM did have a practice pretty much dedicated to this specialty. Google his name and you will come across the details of the lawsuit that ended his career and ruined him financially.
Click to expand...

I know a lot of pods are against cosmetic limb lengthening, so you might be less sympathetic to Dr. Vito, but this lawsuit was pretty bogus.... I just read 4 different sources of the story, and they are all pretty unreal. Ex post facto laws are reminiscent of the nuremburg war trials - not a malpractice suit in Georgia...
 
My post was not any reflection of my opinion of the events, it was just a warning/word of caution. Not all trials end fairly, and even if Dr. Vito won his case, the legal bills alone could have destroyed him.

So my intention was simply to caution those interested to do their homework prior to entering this specialty. There are a lot of undefined areas, which can ultimately result in a nightmare.
 
Ferocity said:
Definitely seems like an interesting niche to super specialize in, thanks for bringing up this topic. 👍

Here's a fellowship open to DPMs: http://www.lifebridgehealth.org/RIAO/LimbReconstructionFellowshipProgram.aspx

And the ortho group where only one of the docs does cosmetic limb lengthening, and has the decency to advise not doing this procedure for cosmetic reasons. Here

Here's the DPM in that ortho group (he's not the one that does cosmetic limb lengthening), he did the fellowship mentioned above:
http://www.lifebridgehealth.org/RIAO/AboutDrBradleyMLamm.aspx
Click to expand...
http://www.acfas.org/fellowshiplamm/
This is a description of the fellowship Dr. Lamm runs, from the ACFAS website. There is the one ACFAS-recognized position, plus one that is not recognized. It seems like an interesting niche, but like PADPM said, it's not a big niche.
 
I think some members on this forum are using the term "cosmetic" very loosely. Realize that brachymetarsia is a result of abnormal development and is not in the same category as telangiectasias (spider veins), wrinkles, or increased adiposity around one's midsection, all of which are considered cosmetic to correct surgically.

During many cases of brachymetatarsia, a patient can be too embarrassed to wear open toed shoegear, or participate in activities that require barefoot such as swimming, spending time on a beach, etc due to the appearance of the obviously short 4th toe. The mental pain, anguish and anxiety that the deformity causes the patient certainly can cause quantitative and qualitative psychological issues and prevents a patient from doing the activities that they like to do. That is just as pathological as a patient's bunion or plantar fasciitis limiting their physical activities and lifestyle.

Please realize that mental pain and anguish are considered just as legitimate a reason for a patient to seek treatment as physical pain and aching. With this considered, most (if not all) surgery for brachymetatarsia is noncosmetic and an insurance company is legitimately and ethically billed, and a patient can get "better" and have their life positively influenced.
 
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