In modern times, ankle surgery has developed rapidly in the West. Traditional podiatric medicine has gradually emerged in the form of regional organizations, and gradually formed and improved its training mechanism, and has been recognized by the public and the medical community. The foot and ankle surgery in regular medicine is separated from the Department of orthopedics and is moving forward at a faster speed.
Overview of modern western ankle surgery
In modern times, ankle surgery began to move forward in two ways, and eventually gradually crossed. Firstly, the development of traditional foot medicine, primarily to treat foot skin diseases, such as chicken eyes, foot cysts, toenail diseases. Another approach stems from traditional surgery or department of orthopedics, mainly in the treatment of foot and ankle injuries and deformity.
In seventeenth Century, medical branches began to appear in France. A chapter in the 1714 textbook on dermatology describes hand and foot diseases, which refer to warts and chicken eyes. Rousseot, a French doctor, was the first to specialize in the treatment of foot diseases. In 1755, he published his first professional book on foot diseases, entitled Foot Eye Dissertation. At that time, foot disease was mainly treated by the corns' excision division, and these people also extracted teeth. In 1802, German doctor Heyman published the book "foot corn eye treatment" in Edinburgh, England. Lewis introduced the treatment of toenail agenesis in 1826 at the Bath Hospital of England. He called himself a foot surgeon and published a book entitled Foot Eye, Cyst, Toenail Disease and Treatment in 1845. Over the next few days, a number of foot surgery techniques were published in the famous British magazine Lancet. In the United States, John established the first foot clinic in 1843.
Since the 18th century, orthopaedics has developed rapidly. Although foot and ankle surgery is still involved in traditional orthopaedics, the mechanism and treatment of foot and ankle injury have been reported. Pott first described ankle fractures in 1756, and thus obtained his own name for the ankle fracture Port fracture [3]. At the end of the 18th century, Dupuytren, a French doctor, and Maisonneuve, a student, described the mechanism of ankle injury and the corresponding fracture characteristics, and obtained ankle fractures under their respective names [4]. In 1800, French doctor Lisfranc described the tarsometatarsal joint injury and introduced the amputation of the joint. Since then, the tarsometatarsal joint is also known as the Lisfranc joint. In 1842, British doctor Syme described an ankle amputation method -Syme amputation.
Since the mid-19th century, with the development of science, technology and economy, foot and ankle surgery has been gradually separated from traditional orthopedics. More and more doctors have embarked on the road of foot and ankle surgery. Therapies for toe deformities such as toe stiffness, hallux valgus, ankle and tendon diseases, and ankle and foot fractures have been reported and improved. The treatment techniques for ankle and ankle diseases gradually become standardized.
Davies CoLley first reported finger stiffness in 1887. Bonney and Macnab first reported closed wedge osteotomy of the metatarsal bone in 1952 to treat the disease. Since then, different closed wedge osteotomies of the metatarsal bone have been continuously reported. Among them, Moberg osteotomy has been widely used. In the treatment of valgus, Chevron osteotomy, Akin's operation and various modified operations based on it, distal soft tissue correction (introduced by McBride in 1928, modified by DuVries and Mann), and Lapidus'operation were clinically proved to be effective. For the treatment of foot and ankle arthritis and degenerative diseases, a variety of arthrodesis has been proposed and improved, such as Keller surgery, Jones surgery, Hoffman plasty, DuVries plasty, Kidner surgery, Siffert surgery and other single-joint and multi-joint arthrodesis has been reported [7]. Repair methods and surgical indications for posterior tibial tendon dysfunction (PTTD), peroneal and Achilles tendon injuries, and bone and joint traumatic diseases of the ankle and foot have also been improved in continuous clinical treatment and trial.
Ankle surgeon training
In western countries, there are two main ways to train foot and ankle surgeons, traditional foot disease medical training mode and formal medical training mode. Although the foot and ankle surgeons trained under these two models are recognized by hospitals, insurance companies and the community, there are different training mechanisms, and the professional basis and degree of the two types of surgeons are also different.
Foot disease medical education sprouted in the middle of nineteenth Century and started in early twentieth Century. Since its inception, podiatrics has not been classified as a formal medical discipline, and today, the podiatric doctor of medicine (DPM) is still different from the doctor of medicine (MD) awarded by a specialized foot and ankle medical college. In 1908, the United States established the system of foot and ankle doctor education; in 1911, the New York School of Foot Diseases (the predecessor of the New York School of Foot and Ankle Medicine) was established; in 1962, the National College of Foot and Ankle Medicine began to enroll; in 1964, the graduates of the College of Foot and Ankle Medicine were awarded DPM degree; in 1978, the College Entrance Examination of Foot and Ankle Medicine With the development of the last 30 years, traditional foot medicine has made great progress both in subject education and in diagnosis and treatment. Now, more than 20,000 traditional foot surgeons are distributed in various states of the United States. The diagnosis and treatment of traditional foot medicine has gradually extended to all surgical diseases below the knee joint, and its cultivation system has gradually developed. Towards maturity and perfection.
At present, only 7 schools in the United States can grant DPM degrees, and about 2000 students are enrolled each year. Students must first have at least three years of college experience or a bachelor's degree; in addition, students are required to major in biology, organic chemistry or physiology during their college years; some schools also have corresponding language requirements. All students must pass the MCAT or GRE examination before entering the foot medical college. Four years of study in podiatrics after admission: first year of basic and introductory studies in podiatrics; second year of study in basic, clinical and podiatric medicine; third year of professional courses including clinical probation (educational); fourth year of clinical practice and elective courses, affiliated to these colleges Hospitals or surgical centers provide students with opportunities for clinical rotation. After completing the college study, most of the students entered the resident training program and received one to two years of further training and rotation. After 1 years of rotation, professional training is further accepted. Then certified by the American Foot and Ankle Medical Career Accreditation Board, a person can obtain a number of certification occupations, including foot and ankle orthopedics, foot and ankle surgery, basic foot and ankle medicine. After entering work, continuing education is required in practice, and most states in the United States require continuing education to retain medical qualifications. European countries have basically the same medical education in foot.
Formal ankle surgery is a branch of orthopaedics in the medical profession. Students have to complete four years of science and engineering studies. After passing MCAT, they will be recruited according to their examination results, introductory letters, personal work and service experience. After entering the medical school, the first two years of basic studies, the second two years of clinical studies, after the end of the MD degree, into the resident stage, but no medical license. Medical license should pass three stages examination, one stage is the basic examination of natural science, usually in the second year of medical college; the second stage is the clinical medical examination, usually before graduation from the medical college and application for resident; the third stage is after one year intern, in addition to medical knowledge, but also to the examination. Ethical and legal issues in bed work. The resident is usually 3 years and is under the guidance of the attending physician. After the end, further training in ankle surgery is usually required for 3 years. It can become a foot and ankle surgeon after obtaining a professional doctor's license and passing the professional doctor's certification.
Development of foot and ankle surgery
In the modern world, foot and ankle surgery developed rapidly in the United States and Europe, and domestic and international organizations were established relatively early. The Foot and Ankle Surgery Association, which originated from foot disease medicine, appeared relatively early than the Foot and Ankle Surgery Association, which originated from orthopedics. The two tissues had a certain degree of intersection in internal composition.
As early as 1895, some foot doctors set up the Pedic Society of New York in New York, New York. In 1912, the National Association of Chiropodists (NAC) was established, the predecessor of the American Podiatric Medical Association (APMA). The Society of Chiropodists and Podiatrists (SCP) was first established in Europe in 1912, but was not formally operational until 1945, when five British HFD organizations were incorporated. Its members are mainly from the Commonwealth countries. The American College of Foot and Ankle Surgeons (ACFAS) was founded in 1942 to promote the development of foot and ankle surgery research and diagnostic technology. Its members are podiatrists (DPM) graduates from podiatric schools. The first World Foot Disease Medical Organization was the Federation International des Podologues (FIP) founded in 1947. It consists of 26 podiatric associations, including the American Foot Association (APMA) and the International Podiatrist's Association of Hong Kong (IPAHK). Its members come from 25 countries in 6 continents. The College International de Medecine et Chirurgie Du pied (CIR) was established in 1958. After that, various regional ankle and ankle surgery organizations were established.
The traditional orthopaedic foot and ankle surgeons were relatively late. In 1949, the American College of Foot and Ankle Orthopedics and Foot Diseases Medicine (ACFAOM) was established. The association consists of foot and ankle orthopaedics and foot surgeons, and aims to promote the development of foot and ankle medicine and the relationship between the two types of surgeons. Exchange and cooperation. Founded in Chicago in 1969, the American orthopaedic foot and Ankle Society (AOFAS) aims to improve the treatment of ankle and foot diseases and provide continuing education in ankle and foot surgery. Its members organize and participate in two major academic conferences each year, namely, the annual American Orthopedic Congress in Winter (sponsored by AAOS) and the American Orthopedic Society in Summer. National foot and ankle surgery annual meeting (AOFAS) [11]. Two major European foot and ankle surgeons were established in 1993, the European Federal Foot and Ankle Soceties (EFFAS, C.I.R. European Branch as its predecessor) and the European Society of Foot and Ankle Surgeons (ESFAS). In 1998, the European Foot and Ankle Society (EFAS) was established in Cologne, Germany. Dereymaeker was the first president of the association. On October 16, 1999, the International Federal Association of Foot and Ankle Surgery (IFFAS) was established in Kyoto, Japan, at its annual meeting of C.I.P. in three years. Its membership organizations include the Asian Foot and Ankle Surgery Association, the European Foot and Ankle Surgery Association, the North American Foot and Ankle Surgery Association and the South American Foot and Ankle Outside Association. The association is aimed at promoting the exchange and development of international surgery on foot and ankle. The first chairman was Haruyasu Yamamoto, a Japanese physician. The first symposium was held in San Francisco, USA, in 2002. The symposium was held every three years and the chairman was replaced. The symposium was held on four continents in turn. The second president was Michael J. Coughlin, an American physician, and the second was held in Naples, Italy, in 2005; the second was Sandro Giannini, an Italian physician; the third was held in Bahia, Brazil, in 2008; the fourth was Osny Salomao, a Brazilian physician; and the fourth was to be held in 2011. It was held in Japan.
En la actualidad, sólo hay siete escuelas en los Estados Unidos que pueden conceder el título de DPM, con un total de aproximadamente 2.000 alumnos por año.Los alumnos tienen derecho a una experiencia universitaria o a un título de licenciado por lo menos durante tres años; además, los estudiantes que asisten a la escuela asisten a la Universidad, como la biología, la química orgánica o la fisiología, y algunas escuelas tienen los correspondientes requisitos lingüísticos.Todos los estudiantes deben aprobar el examen MCAT o gre antes de ingresar a la facultad de medicina.- el segundo año de estudios clínicos, incluidos los estudios clínicos y los cursos optativos.Los hospitales o los centros de cirugía ofrecerán a los estudiantes la oportunidad de desplazarse por turnos clínicos.Tras la finalización del estudio de la Escuela Superior, la gran mayoría de los estudiantes ingresaron en el programa de formación de médicos hospitalarios, con un nuevo desarrollo y rotación en un período de uno a dos años.Después de un año de rotación, se recibe más capacitación profesional.A continuación, la Junta de certificación de la profesión médica de los Estados Unidos certifica que una persona puede obtener múltiples profesiones certificadas, en particular la hueso tobillo, la cirugía de tobillo y la medicina de tobillo.En la práctica, la mayor parte de los Estados de los Estados Unidos han pedido que se mantenga la educación permanente para mantener el derecho a la medicina.La enseñanza de la medicina en los países europeos es esencialmente la misma que en los Estados Unidos.
La cirugía del tobillo oficial es una rama de la especialidad de la profesión médica, y los estudiantes tienen que completar los cuatro años de estudios de ingeniería y, por conducto de la MCAT, la selección basada en los méritos, las cartas de presentación, el trabajo personal y la experiencia de los servicios.Después de haber ingresado en la facultad de medicina, la base de los dos años anteriores y el último de los dos años de clinica, se concedió el título de D después del final de la escuela, en la etapa de hospitalización, sin licencia médica.La licencia médica se realiza por tres etapas, una de las cuales es el examen básico de ciencias naturales, generalmente en el segundo grado de la facultad de medicina; ii) el examen médico clínico, en general, antes de la graduación de la facultad de medicina y antes de que se solicite un médico residente; y tres etapas, después de un año de pasantías, además de los conocimientos médicos.La ética, la ley, etc. en el trabajo de la cama.Los médicos son hospitalizados por un período de tres años y reciben atención médica bajo la dirección del médico principal.Una vez terminada, se necesita más capacitación en el tobillo, por lo general durante tres años.La obtención de una licencia de medicina profesional y la certificación de un profesional de los Estados Unidos para ser cirujano tobillo.
Desarrollo de la cirugía de tobillo
En el mundo moderno, la cirugía de tobillo en los Estados Unidos y Europa se ha desarrollado con mayor rapidez, y el establecimiento de organizaciones nacionales e internacionales es relativamente pronto.Las asociaciones de cirugías de tobillo que se originan en la medicina de las enfermedades son relativamente anteriores a las asociaciones de cirugías de tobillo que provienen de la hueso oficial, y las dos organizaciones tienen cierto grado de intersección en su composición interna.
Ya en 1895, varios médicos de la sociedad de Nueva York se establecieron en Nueva York (pedic Society of New York) en Nueva York.En 1912 se creó la Asociación de médicos de los Estados Unidos (National Association of chiropodists, NAC), precursora de la American Medical Medical Association (American Medical Medical Association, apma).La Asociación Europea de médicos de enfermedades (The Society of chiropodists and bodiatrists, SCP) se estableció en 1912 por primera vez en Europa, pero hasta la integración de cinco organizaciones británicas en 1945 comenzó a funcionar oficialmente, y actualmente sus miembros proceden principalmente de los países del Commonwealth.La Asociación Americana de médicos de tobillo (American College of Foot and Ankle Surgeons, acas), creada en 1942, tiene por objeto promover el desarrollo de las técnicas de investigación y tratamiento de los tobillos, y los miembros de la Asociación están integrados por un médico que se graduó de las facultades de Medicina de los tobillos (DPM).La primera organización mundial de la medicina, fundada en 1947, está integrada por 26 asociaciones de enfermos, entre ellos la Asociación de médicos de los Estados Unidos (apma) y la Asociación Internacional de médicos de Hong Kong (International podiatrst 's Association of Hong Kong, iphak).Sus miembros proceden de 25 países de seis continentes.Creación en 1958 de la facultad de Medicina de la comunidad internacional de enfermedades, la Cir.Posteriormente se creó una serie de organizaciones extranjeras de tobillo de tobillo.