INNOVATORS Gold Award - New Orleans City Business

MEDICAL
PHOTO BY FRANK AYMAMI
Dr. James Laborde, an orthopaedic surgeon with Orthopaedic Associates of New Orleans, has pioneered a procedure to lengthen tendons in the foot to heal ulcers.
Orthopaedic Associates
of New Orleans
Key innovation: lengthening tendons to heal foot ulcers
Biggest clients: diabetic patients.
Where they’re based: New Orleans
Top executive: Dr. James Laborde, Dr. Lance Estrada
and Dr. Kevin Watson, partners
Year introduced: 1995
IMAGINE BEING A diabetic patient with chronic foot
ulcers who is told that your foot or leg must be amputated.
Then imagine your relief when another doctor tells you an
outpatient procedure may help prevent an amputation.
In the United States, more than 80,000 amputations
are performed each year on diabetic patients and 85 percent
of them are because of foot ulcers, according to an
American Foot and Ankle Society study. If foot ulcers
could be eliminated, most of these amputations could be
prevented.
Dr. James Laborde, an orthopaedic surgeon with
Orthopaedic Associates of New Orleans, has pioneered a
procedure where patients with chronic foot ulcers can
have surgery to lengthen their tendons, which in turn can
heal the ulcers.
“In 1995 I was doing tendon lengthening in children
with cerebral palsy,” Laborde said. “One child got an ulcer,
and after the surgery the ulcer went away. I had another
patient with diabetes who got an ulcer and was sent to
wound care. One year later the patient was told they needed
an amputation. I did tendon lengthening and the patient did
not need the amputation.”
Laborde said the popular opinion is that poor circulation
causes foot ulcers.
“Ulcers are really caused by nerve damage, a tightness of
the tendons, and lack of feeling, not circulation problems,”
Laborde said.
According to the Orthopaedic Association of New
Orleans’ Web site, www.footulcer.info, ulcers are caused by
pressure on the forefoot.
For toe ulcers, Laborde performs a 15-minute office procedure
to surgically lengthen the flexor tendons on the toe.
For ulcers on the ball of the foot, there is a 45-minute outpatient
procedure that lengthens the heel cord. There is also a
one-hour procedure to lengthen the calf muscle, in which
the patient is able to walk immediately after the surgery.
“It’s been very gratifying to see that the patients realize it
works,” Laborde said.
He stressed that most ulcers can be prevented if diabetics
are told by their physician to stretch their calf tendons for
several minutes every day.•
— Lisa Bacques
New Orleans CityBusiness 39A