Increased Access to Expert Foot and Ankle Care at AHN

From acute injuries and chronic pain to complex deformities and diabetes-related complications, the Foot and Ankle Division within AHN's Department of Orthopaedics provides comprehensive care for a broad range of conditions. The addition of Dane Wukich, MD, further strengthens its capabilities, particularly in treating complex foot and ankle conditions. With 44 years of surgical experience, Dr. Wukich brings internationally recognized expertise in Charcot neuroarthropathy, along with extensive experience in foot and ankle trauma, reconstruction, and diabetic limb preservation.

When to refer for specialty foot and ankle care

Specialty evaluation can help identify appropriate treatment options for patients with acute injuries, structural abnormalities, or persistent foot and ankle symptoms. Providers should consider referral to the Foot and Ankle Division for evaluation and treatment for conditions including:

• Foot and ankle fractures, including calcaneus and talus fractures
• Sports-related injuries
• Achilles and other tendon injuries
• Flatfoot, high arches, and other deformities
• Chronic foot or ankle pain

Referral is not limited to acute injuries. Patients experiencing persistent pain or functional limitations, even months or years after an initial injury, may benefit from specialty evaluation to determine whether additional treatment could improve their mobility and quality of life.

“Untreated foot and ankle conditions can lead to other comorbidities and generally decrease quality of life,” said Dr. Wukich. “There are a lot of options that relieve pain, restore movement, and can help people remain active on their feet.”

Complex foot and ankle complications in patients with diabetes

Dr. Wukich emphasizes the importance of early referral for patients with diabetes — particularly those with conditions that increase the risk of serious foot and ankle complications, including:

• Peripheral neuropathy, which can impair protective sensation, allowing minor injuries to go unnoticed and progress to more serious complications.
• Peripheral artery disease, which can reduce blood flow to the lower extremities, impair wound healing, and increase the risk of infection and limb loss.
• Charcot neuroarthropathy, a progressive condition affecting the bones and joints of the foot and ankle that can initially be mistaken for gout, cellulitis, deep vein thrombosis, or infection.

Providers should be alert to unexplained swelling, redness, or warmth — especially when patients do not recall a specific injury. Without timely evaluation and treatment, seemingly minor injuries can progress to fractures, dislocation, open wounds, infection, and potentially amputation.

“Because Charcot neuroarthropathy’s symptoms are similar to other conditions, it can be overlooked or misdiagnosed,” said Dr. Wukich. “It’s better to be safe and evaluate patients as a precaution, as significant deformity and dislocation can develop rapidly.”

For patients with suspected Charcot neuroarthropathy or other rapidly progressing diabetes-related foot and ankle complications, prompt communication with the Foot and Ankle Division is encouraged to facilitate timely evaluation.

Restoring function through individualized care

Treatment decisions are guided by each patient's symptoms, overall health, and functional goals. While Dr. Wukich and the AHN Foot and Ankle Division offer advanced surgical capabilities, nonsurgical interventions are often considered first, including:

• Physical therapy
• Immobilization with a boot
• Platelet-rich plasma injections (PRP) and other injections

When conservative treatment does not provide adequate relief or limb viability is threatened, surgical intervention may be appropriate. Dr. Wukich offers both minimally invasive and traditional open procedures, selecting the approach best suited to the patient's condition and treatment goals.

“A central goal of orthopaedic treatment is restoring function and helping patients return to activities important to their health and quality of life,” said Dr. Wukich.

Multidisciplinary care and provider collaboration

For patients with complex foot and ankle conditions, access to multidisciplinary care can be essential. At AHN, the Foot and Ankle Division collaborates with specialists across vascular surgery, plastic surgery, hospital medicine, and infectious disease to address the full scope of a patient's medical needs.

This coordinated approach extends to referring providers. Dr. Wukich emphasizes the importance of communication before and after treatment, from coordinating pre-operative medical clearance to keeping providers informed about surgical procedures and post-operative care. This ongoing partnership supports continuity of care as patients recover and transition back to their referring providers.

How to refer

To learn more or refer a patient for specialized foot and ankle care through the AHN Department of Orthopaedics, call 844-MD-REFER 844-637-3337 or submit a referral online.