Limitations On Case Submissions

      Candidates for certification are required to submit seventy-five diverse cases of their own experience. The case mix is determined by the candidate, but there are limitations imposed on the number of cases of various types that may be submitted. In the tables which follow, procedures are broken down into categories. Candidates may submit fewer cases than the stated maximums for any procedure or any category. Submissions cannot exceed either the maximum allowable number indicated for the named procedures, or the maximum allowable number indicated for each category. Candidates are not required to submit cases in all categories.

ARTHRODESIS category maximum: 20	Procedure Maximum	comments
Interphalangeal	5	By any means, with/without removable fixation
Interphalangeal with screw	8	Permanent internal fixation device
Metatarsophalangeal	5	By any means
Tarsometatarsal	10	By any means
Intertarsal	15	By any means
Subtalar triple	15	By any means
Ankle mortice	15	By any means

FRACTURES category maximum: 30	Procedure Maximum	comments
Phalangeal, closed reduction	5	Must submit pre- and postoperative x-rays with op report
Phalangeal, open reduction	10
Metatarsal, closed reduction	5	Must submit pre- and postoperative x-rays with op report
Metatarsal, open reduction	15
Metatarsal, multiple, open reduction	15
Tarsal, closed reduction	5	No cuneiforms; submit pre- and post op x-rays with report
Tarsal, open reduction	15
Malleolar, single, closed reduction	5	Must submit pre- and postoperative x-rays with op report
Malleolar, single, open reduction	15
Bimalleolar, closed reduction	5	Must submit pre- and postoperative x-rays with op report
Bimalleolar, open reduction	15
Trimalleolar, open reduction	15

OSTEOTOMIES category maximum: 30	Procedure Maximum	comments
Phalanx, hallux	5
Phalanx, other	10
Metatarsal, lesser, chevron or simple DFWO	5
Metatarsal, lesser, step-down, peg-in-hole, etc	15
Metatarsal, lesser, lengthening	15
Metatarsal, 1st, base wedge, opening/closing	5	Performed without bunionectomy
Metatarsal, 1st, base, DFWO	5
Metatarsal, multiple	5
Tarsal, cuboid	15
Tarsal, navicular	5
Tarsal, talus	15
Tarsal, calcaneus	15

OTHER BONE PROCEDURE category maximum: 30	Procedure Maximum	comments
Grafts, any purpose, not elsewhere included	15	Any site, any source; excludes bone chip pack for lytic lesions.
Subtalar stay peg arthroeresis	15
Other procedures	*	Contact ACCPPS office

AMPUTATION category maximum: 30	Procedure Maximum	comments
Symes, digital	10	Each such case must be proved with a pathology report which makes it clear that there has been an amputation of a body segment or part of segment, and the specimen must contain appropriate and sufficient soft tissue and bone to substantiate the case. "Bone only" amputations are not acceptable.
Digit	15
Digit, multiple	15
Transmetatarsal	20
Other -- Contact ACCPPS office	*

SOFT TISSUE category maximum: 30	Procedure Maximum	comments
Ankle stabilization	15	Excludes repair of torn ligament by suturing
Excision, foreign body	15	Deep to superficial fascia (no prostheses or fixation devices)
Removal of prosthesis or fixation device	5	Must not have been implanted by same surgeon.
Excision, ganglion	15
Excision, neuroma	15
Excision, other mass, nonmuscle	10	Deep to superficial fascia
Excision, mass, muscle	15
Fasciotomy/fasciectomy, plantar	15	Separate procedure, without heel spur excision
Ligament repair by suture	15	Ligament divided by trauma or late effect of earlier surgery
Ligament repair by graft	15	Ligament divided by trauma or late effect of earlier surgery
Tarsal tunnel syndrome/other decompression	15
Syndactylization/desyndactylization	15
Skin, graft, rotation flap	15	Closure of skin defect not created by concurrent procedure
Skin, graft, other	15	Closure of skin defect not created by concurrent procedure
Skin, other plastic repair	10	Must eliminate nerve entrapment or restore joint function
Skin, excisions, lesion, with primary closure	10
Tendon, tenoplasty/repair	15	Lengthen, shorten, reroute, repair preop defect; no tenotomies
Tendon transfer	15	Excludes tendons of intrinsic muscles of the foot
other procedures	*	Call ACCPPS office

MAJOR RECONSTRUCTION category maximum: 50	Procedure Maximum	comments
Multiple procedures for repair of major trauma or correction of global deformity.	50	Trauma: open reduction of three or more fractures, at least three of which must be nondigital. Correction of global deformity: procedures requiring multiple osseous procedures and/or multiple extrinsic tendon transfers, e.g. midfoot sag, talipes equinovarus, calcaneovalgus, forefoot equinus, and similar procedures.