INTRODUCTION

Education is a painful, continual and difficult task to be done by kindness, by watching, by warning, by precept and by praise, but above all, by example.

    —John Ruskin

What an honor and privilege it is to present this special issue of our profession’s most widely circulated journal to you, our colleagues and friends. It is through this special issue that the Podiatric Surgical Residency Program of St Vincent Charity Hospital in Cleveland, Ohio, is able to share with you some of our ideas and thoughts, experiences, and innovative techniques.

St Vincent Charity Hospital, a partnership component of The Sisters of Charity of St Augustine Health System and University Hospital Health System, has been our new home since relocation three years ago of our well-known PSR-24 program, which had its roots at the Mt Sinai Medical Center in Cleveland. Dr. Michael Forman, co-director of our current program, founded the initial program in 1984. We are very proud of our current three-year Podiatric Surgical Residency Program, consisting of a complement of six residents from four different colleges of podiatric medicine; our emphasis is on a true comprehensive approach to surgery of the foot, ankle, and lower leg, whether it be simple or complex.

We hope that you find this special issue stimulating, educational, clinically relevant, and thus helpful in changing the lives of those you treat. Our lead article, “Predislocation Syndrome: Progressive Subluxation/Dislocation of the Lesser Metatarsophalangeal Joint,” provides insight into a common, disabling, often misdiagnosed clinical entity that has been the subject of recent podiatric and orthopedic literature. The second article, “Enhanced Tenodesis for Retrocalcaneal Surgery,” introduces a new technique to provide optimal tenodesis following extensive detachment of the tendo Achillis, which may be necessary when managing the complex entity of retrocalcaneal enthesitis. A much needed appreciation of the initial presentation of the acute diabetic Charcot foot is the foundation of the article “Evaluation and Treatment of Stage 0 Charcot’s Neuroarthropathy of the Foot and Ankle.” Practical pearls are offered for the diagnosis and treatment of this very complex disease in its earliest stages, to help avoid the well-known complications and sequelae of ulceration, infection, and amputation. “The Jones Compression Bandage: Review and Clinical Applications” details a specific technique to control lower-extremity edema, regardless of its etiology, and is based on 18 years of practical clinical experience of the senior author. The article “Syme’s Amputation: Surgical Technique, Prosthetic Considerations, and Case Reports” will stimulate new thinking on the most appropriate and functional level of amputation when amputation is the best treatment for a complex condition. Specific technical pearls are offered to make the outcome predictably successful. Finally, “Synovial Osteochondromatosis: A Case Report and Review of the Literature” will stimulate the reader to think further about the differential diagnosis of intra- and extra-articular pain of the foot and ankle.

One of the most rewarding aspects of my professional career has been the personal and professional growth I have enjoyed as a result of educating and training students and residents. The mutual sharing and exchange of ideas, thoughts, and experiences stimulates our minds and fosters advancement at many levels. Our team dedication and commitment to excellence coupled with the personal and unselfish giving of time, effort, and energy provided the fuel necessary to make this special issue a reality. I congratulate our current and past residents whose persistence and commitment to this project have been steadfast.

From the earliest days of my professional career, I have been extremely fortunate to learn so much from so many who have provided leadership and served as an example in both their personal and professional lives. To list each of these important individuals would be difficult if not impossible to do. I know and you know who you are, and to each of you I say “thank you” from my heart and soul.

Finally, on a more personal note, the rewards and satisfaction I have enjoyed from my chosen profession are exceeded only by those of being a son, brother, father, and husband. It is this steadfast, unwavering family support structure that has given me the energy, the inspiration, the encouragement, and the time to pursue my professional activities. To my wonderful parents, my beautiful wife, and my five terrific children, who help me love life a little more each day, I dedicate this small accomplishment to you.