PLS Logging

Expanded List of Categories for Foot Certification Case Review

Please ensure that you correctly log procedures into PLS. Case reviewers evaluate procedures based on the category you have assigned. For example, if a joint salvage procedure with cheilectomy only is logged as a joint salvage procedure with distal metatarsal osteotomy, you will receive a low or failing score for that case. Open management of fracture or MTPJ dislocation cases must include internal or external fixation. Procedures are evaluated based on surgical decision-making, preoperative clinical assessment, preoperative radiographic assessment, perioperative ancillary laboratory assessment, technical skills assessment, and outcomes analysis.

Each category in “italics” has an allowable maximum of 2 of the 30 required cases.
Each category in “non-italics” has an allowable maximum of 15 of the 30 required cases.

Hallux Valgus Surgery

2.1.3 bunionectomy with phalangeal osteotomy
2.1.4 bunionectomy with distal first metatarsal osteotomy
2.1.5 bunionectomy with first metatarsal base or shaft osteotomy
2.1.6 bunionectomy with first metatarsocuneiform fusion
2.1.7 MTPJ fusion
2.1.8 MTPJ implant
2.1.10 bunionectomy with double correction with osteotomy and/or arthrodesis

Hallux Limitus Surgery

2.2.1 cheilectomy
2.2.2 joint salvage with phalangeal osteotomy (Kessel- Bonney, enclavement)
2.2.3 joint salvage with distal metatarsal osteotomy
2.2.4 joint salvage with first metatarsal shaft or base osteotomy
2.2.5 joint salvage with first metatarsocuneiform fusion
2.2.6 MTPJ fusion
2.2.7 MTPJ implant

Other First Ray Surgery

2.3.2 osteotomy (e.g., dorsiflexory)
2.3.3 metatarsocuneiform fusion (other than for hallux valgus or hallux limitus)
2.3.4 amputation
2.3.5 management of osseous tumor/neoplasm (with or without bone graft)
2.3.6 management of bone/joint infection (with or without bone graft)
2.3.7 open management of fracture or MTPJ dislocation with fixation
2.3.8 corticotomy with callus distraction

Osseous Foot Surgeryy

4.5 lesser MTPJ implant
4.6 central metatarsal osteotomy
4.7 bunionectomy of the fifth metatarsal with osteotomy
4.8 open management of lesser metatarsal fracture(s)
4.10 amputation (lesser ray, transmetatarsal amputation (TMA)
4.11 management of bone/joint infection distal to the tarsometatarsal joints (with or without bone graft)
4.12 management of bone tumor/neoplasm distal to the tarsometatarsal joints (with or without bone graft)
4.13 open management of tarsometatarsal fracture/dislocation
4.14 multiple osteotomy management of metatarsus adductus
4.15 tarsometatarsal fusion
4.16 corticotomy/callus distraction of lesser metatarsal

Elective – Soft-tissue

5.1.1 plastic surgery techniques involving the midfoot, rearfoot or ankle
5.1.2 tendon transfer involving the midfoot, rearfoot, ankle, or leg
5.1.4 soft-tissue repair of complex congenital foot/ankle deformity (clubfoot, vertical talus)
5.1.5 primary or secondary repair of ligamentous structures
5.1.6 tendon augmentation/supplementation/restoration

Elective – Osseous

5.2.4 midfoot, rearfoot, or ankle fusion
5.2.5 midfoot, rearfoot, or tibial osteotomy
5.2.6 coalition resection
5.2.7 open management of talar dome lesion (with or without osteotomy)
5.2.8 ankle arthrotomy with removal of loose body or other osteochondral debridement
5.2.9 ankle implant
5.2.10 corticotomy or osteotomy with callus distraction/ correction of complex deformity of the midfoot, rearfoot, ankle, or tibia

Nonelective – Soft tissue

5.3.1 repair of acute tendon injury
5.3.2 repair of acute ligament injury
5.3.3 microscopic nerve/vascular repair of the midfoot, rearfoot, or ankle
5.3.4 excision of soft-tissue tumor/mass of the foot, ankle, or leg (with reconstructive surgery)
5.3.6 open repair of dislocation (proximal to tarsometatarsal joints)

Nonelective – Osseous

5.4.1 open repair of adult midfoot fracture
5.4.2 open repair of adult rearfoot fracture
5.4.3 open repair of adult ankle fracture
5.4.4 open repair of pediatric rearfoot/ankle fracture or dislocation
5.4.5 management of bone tumor/neoplasm (with or without bone graft)
5.4.6 management of bone/joint infection (with or without bone graft)
5.4.7 amputation proximal to the tarsometatarsal joints
5.4.9 application of multiplanar external fixation midfoot, rearfoot, and ankle (does not include mini or mono rails).

RRA Surgery Certification requires logging a minimum of 30 RRA procedures. Of this 30, ABFAS requires logging a minimum of 13 procedures from the following list.

RRA Elective Osseous (minimum 10)

5.2.4 midfoot, rearfoot, or ankle fusion
5.2.5 midfoot, rearfoot, or tibial osteotomy
5.2.9 ankle implant
5.2.10 corticotomy or osteotomy with callus distraction/correction of complex deformity of the midfoot, rearfoot, ankle, or tibia

RRA Nonelective Osseous (minimum 2)

5.4.1 open repair of adult midfoot fracture
5.4.2 open repair of adult rearfoot fracture
5.4.3 open repair of adult ankle fracture
5.4.4 open repair of pediatric rearfoot/ankle fracture or dislocation

Please ensure that you correctly log procedures into PLS. Case reviewers evaluate procedures based on the category you have assigned. Case reviewers evaluate procedures based on the category you have assigned. Open management of fracture dislocation cases must include internal or external fixation. Procedures are evaluated based on surgical decision-making, preoperative clinical assessment, preoperative radiographic assessment, perioperative ancillary laboratory assessment, technical skills assessment, and outcomes analysis.

1. Digital Surgery category (lesser digit or hallux)

1.1 partial ostectomy/exostectomy
1.2 phalangectomy
1.3 arthroplasty (interphalangeal joint [IPJ])
1.4 implant (IPJ), silastic implant or spacer
1.5 diaphysectomy
1.6 phalangeal osteotomy
1.7 fusion (IPJ)
1.8 amputation
1.9 management of osseous tumor/neoplasm
1.10 management of bone/joint infection
1.11 open management of digital fracture/dislocation
1.12 revision/repair of surgical outcome
1.13 other osseous digital procedure not listed above

2. First Ray Surgery (30 procedures). Procedures isolated to the hallux should be logged as digital procedures.

Hallux Valgus Surgery

2.1.1 bunionectomy (partial ostectomy/Silver procedure) with or without capsulotendon balancing procedure
2.1.3 bunionectomy with phalangeal osteotomy
2.1.4 bunionectomy with distal first metatarsal osteotomy
2.1.5 bunionectomy with first metatarsal base or shaft osteotomy
2.1.6 bunionectomy with first metatarsocuneiform fusion
2.1.7 MPJ fusion
2.1.8 MPJ implant
2.1.9 MPJ arthroplasty
2.1.10 bunionectomy with double correction with osteotomy and/or arthrodesis

Hallux Limitus Surgery

2.2.1 cheilectomy
2.2.2 joint salvage with phalangeal osteotomy (Kessel- Bonney, enclavement)
2.2.3 joint salvage with distal metatarsal osteotomy
2.2.4 joint salvage with first metatarsal shaft or base osteotomy
2.2.5 joint salvage with first metatarsocuneiform fusion
2.2.6 MPJ fusion
2.2.7 MPJ implant
2.2.8 MPJ arthroplasty

First Ray Surgery

2.3.1 tendon transfer/lengthening
2.3.2 osteotomy (e.g., dorsiflexory)
2.3.3 metatarsocuneiform fusion (other than for hallux valgus or hallux limitus)
2.3.4 amputation 2.3.5 management of osseous tumor/neoplasm (with or without bone graft)
2.3.6 management of bone/joint infection (with or without bone graft)
2.3.7 open management of fracture or MPJ dislocation with fixation
2.3.8 corticotomy with callus distraction
2.3.10 other first ray procedure not listed above

3. Other Soft-tissue Foot Surgery

3.1 excision of ossicle/sesamoid
3.2 excision of neuroma
3.3 removal of deep foreign body (excluding hardware removal)
3.4 plantar fasciotomy
3.5 lesser MTPJ capsulotendon balancing
3.6 tendon repair, lengthening, or transfer involving the forefoot (including digital FDL transfer)
3.7 open management of dislocation (MPJ/tarsometatarsal)
3.8 incision and drainage/wide debridement of soft-tissue infection includes foot, ankle, and leg
3.9 plantar fasciectomy/plantar fibroma resection
3.10 excision of soft-tissue tumor/mass of the foot (without reconstructive surgery) includes foot, ankle, and leg
3.12 plastic surgery techniques (including skin graft, skin plasty, flaps, syndactylization, desyndactylization, and debulking procedures limited to the forefoot)
3.13 microscopic nerve/vascular repair (forefoot only)
3.14 other soft-tissue procedures not listed above (limited to the foot)
3.16 external neurolysis/decompression (including tarsal tunnel)
3.17 decompression of compartment syndrome (includes foot or leg)

4. Osseous Foot Surgery

4.1 partial ostectomy includes foot, ankle, and leg
4.2 lesser MPJ arthroplasty
4.3 bunionectomy of the fifth metatarsal without osteotomy
4.4 metatarsal head resection (single or multiple)
4.5 lesser MPJ implant
4.6 central metatarsal osteotomy
4.7 bunionectomy of the fifth metatarsal with osteotomy
4.8 open management of lesser metatarsal fracture(s)
4.9 harvesting of bone graft includes foot, ankle and leg
4.10 amputation (lesser ray, transmetatarsal amputation (TMA])
4.11 management of bone/joint infection distal to the tarsometatarsal joints (with or without bone graft)
4.12 management of bone tumor/neoplasm distal to the tarsometatarsal joints (with or without bone graft)
4.13 open management of tarsometatarsal fracture/dislocation
4.14 multiple osteotomy management of metatarsus adductus
4.15 tarsometatarsal fusion 4.16 corticotomy/callus distraction of lesser metatarsal
4.17 revision/repair of surgical outcome in the forefoot
4.18 other osseous procedures not listed above (distal to the tarsometatarsal joint)
4.19 detachment/reattachment of Achilles tendon with partial ostectomy

5. Reconstructive Rearfoot/Ankle Surgery (30 procedures) Elective –Soft-tissue

5.1.1 plastic surgery techniques involving the midfoot, rearfoot or ankle
5.1.2 tendon transfer involving the midfoot, rearfoot, ankle, or leg
5.1.3 tendon lengthening involving the midfoot, rearfoot, ankle, or leg
5.1.4 soft-tissue repair of complex congenital foot/ankle deformity (clubfoot, vertical talus)
5.1.5 primary or secondary repair of ligamentous structures
5.1.6 tendon augmentation/supplementation/ restoration
5.1.7 open synovectomy of the rearfoot/ankle
5.1.9 other elective reconstructive rearfoot/ ankle soft-tissue surgery not listed above

Elective – Osseous

5.2.1 operative arthroscopy
5.2.3 subtalar arthroereisis
5.2.4 midfoot, rearfoot, or ankle fusion
5.2.5 midfoot, rearfoot, or tibial osteotomy
5.2.6 coalition resection
5.2.7 open management of talar dome lesion (with or without osteotomy)
5.2.8 ankle arthrotomy with removal of loose body or other osteochondral debridement
5.2.9 ankle implant
5.2.10 corticotomy or osteotomy with callus distraction/ correction of complex deformity of the midfoot, rearfoot, ankle, or tibia
5.2.11 other elective reconstructive rearfoot/ ankle osseous surgery not listed above

Nonelective – Soft tissue

5.3.1 repair of acute tendon injury
5.3.2 repair of acute ligament injury
5.3.3 microscopic nerve/vascular repair of the midfoot, rearfoot, or ankle
5.3.4 excision of soft-tissue tumor/mass of the foot, ankle, or leg (with reconstructive surgery)
5.3.6 open repair of dislocation (proximal to tarsometatarsal joints)
5.3.7 other nonelective reconstructive rearfoot /ankle soft-tissue surgery not listed above

Nonelective – Osseous

5.4.1 open repair of adult midfoot fracture
5.4.2 open repair of adult rearfoot fracture
5.4.3 open repair of adult ankle fracture
5.4.4 open repair of pediatric rearfoot/ankle fracture or dislocation
5.4.5 management of bone tumor/neoplasm (with or without bone graft)
5.4.6 management of bone/joint infection (with or without bone graft)
5.4.7 amputation proximal to the tarsometatarsal joints
5.4.8 other nonelective reconstructive rearfoot/ankle osseous surgery not listed above
5.4.9 application of multiplanar external fixation midfoot, rearfoot, and ankle (does not include mini or mono rails)