How do Orthopaedic Foot and Ankle Specialists and Podiatrists Differ in Scope of Practice?

Orthopaedic & Spine Center


Dr. Joel StewartJoel D. Stewart, MD

In my last article, I discussed the educational and training differences between a fellowship trained orthopedic foot and ankle specialist and a podiatrist.  Both are specialists who diagnose and treat injury to and conditions of the foot, ankle, and leg.  Today, I’ll discuss the differences and similarities in our medical practices.

Basic Foot and Ankle Problems – Both a Podiatrist and Ortho Foot and Ankle Physician provide care for basic problems of the foot and ankle.  We diagnose and treat such conditions as arthritis, gout, sprains or strains, hammertoes, nerve problems of the foot, etc.  Podiatrists will also treat ingrown toenails, corns and calluses, ulcers of the foot, fungal and bacterial infections of the skin and toenails, which most Orthopaedists don’t do.

Diabetic Foot Care – Both Orthopaedists and podiatrists offer foot care for diabetics.  Some Podiatrists will offer toenail trimming.  Both physicians will manage diabetic ulcers and create specialized orthotics specifically for diabetic foot and ankle issues.  Orthopaedists, and some Podiatrists, will also perform surgery for diabetic foot issues requiring toe and/or foot amputations and the surgical reconstruction of the foot and ankle due to Charcot Syndrome.  The treatment of Peripheral Neuropathy (nerve-related pain due to diabetes) is usually referred to an Interventional Pain Management Specialist for long-term care and management.

Fractures of the foot and ankle – Both Orthopaedists and Podiatrists, are qualified to treat broken bones, either conservatively with casting/booting or those that require surgical intervention.  For traumatic injuries to the foot and ankle (car accidents, falls, etc.), an Orthopaedic Foot and Ankle Specialist will be called to the hospital to provide acute treatment and surgery if necessary.  Some larger hospitals also have surgical Podiatrists on call for these injuries.

Bunionectomies – The surgical treatment of bunions may be simple or extremely complex, involving not only the removal of the boney growth at the great toe, but also can include realignment of the metatarsal bones in the foot and lengthening or tightening of tendons and ligaments.  All Orthopaedic Foot and Ankle specialists are qualified to do these surgeries, as are surgical Podiatrists.

Ankle Joint Replacement and Arthrodesis (Joint Fusion) Surgery – These two surgeries are intricate and often require extensive reconstruction of other parts of the foot, ankle and lower leg.  These cases can be very volume dependent.  Most Orthopaedic Foot and Ankle Surgeons are trained to perform these surgeries due to their intensive fellowship training, but not all of them do these procedures. There are also Podiatrists who perform these procedures.  Because of the complexity of the surgeries, it’s important to find a surgeon who has a good track record of positive outcomes for patients. If you are considering this type of surgery, don’t be afraid to ask your physician how often they do them and do they feel comfortable doing these procedures.


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