Podiatry remains a relatively unusual healthcare profession in that it is defined by a focus on a discrete body part, rather than a specific role, philosophy or approach to treatment. As a profession it has been broadly depicted in the international literature as a healthcare speciality devoted to the treatment and prevention of afflictions of the foot.

However, such a broad all-embracing definition does little to illuminate the range of roles, skills and knowledge that make up modern podiatric practice.

A more specific definition of the role of the podiatrist is ‘dealing with the prevention, diagnosis, treatment and rehabilitation of medical and surgical conditions of the feet and lower limbs’.

The aim of the podiatrist is to identify the risk factors involved and to treat and prevent certain complications. Detailed examination such as vascular and neurological assessment, assessing mobility and biomechanics play a major role in the diagnosing and treating of foot complications.

Podiatry services offered at different health centres include routine foot care such as removal of corns and callosities.

The conditions podiatrists treat include those resulting from bone and joint disorders such as arthritis and soft tissue and muscular pathologies, as well as neurological and circulatory disease. Podiatrists are also able to diagnose and treat any complications of the above which affect the lower limb. Foot injuries and infections resulting from sport or other activities are also diagnosed and treated by podiatrists.

In Malta podiatry is a relatively new profession. From four podiatrists and just 4,000 treatments offered in the first year of service 30 years ago, nowadays there is a strong 50-podiatrist team offering more than 130,000 treatments annually. The number of clinics and specialities has also mushroomed over these years.

Services currently offered include:

Core podiatry which includes routine foot care such as corns, callosities, foot infections (fungal, bacterial or viral infections), nail pathologies and detailed examination including biomechanical, vascular and neurological examination.

Gait analysis. This is carried out at Birkirkara Health Centre where there is a clinic specifically dedicated to biomechanics. This clinic offers a detailed biomechanical and gait analysis through visual and computerised means.

Foot screening. Neurological and vascular screening is offered to all patients with diabetes at practically all clinics. When patients who undergo the initial tests have poor results, they are referred for further investigation to two more specialised clinics in the Floriana and Birkirkara health centres.

Podopaediatrics. A specialised clinic focusing on the examination and treatment of children was introduced two years ago at the Birkirkara health centre. This clinic had an instant success and after just a year the staff had to be doubled to meet the demands of the public.

Rheumatoid clinic. Patients with rheumatoid arthritis can visit a specialised clinic twice a week.

Diabetes. A strong team of podiatrists have specialised in the examination and treatment of patients with diabetes. As a team, and in collaboration with other podiatrists in the Tissue Viability Unit, and Orthotics and Prosthetic Units and other healthcare professions, they work hard to reduce the rate of amputations through treatments, education and preventive measures.

Nail surgery. There is a clinic specifically dedicated to nail surgery.

Wound management. The podiatrists at the health centres form part of the Tissue Viability Unit team at Mater Dei Hospital, although they are located in the community through the health centres. They collaborate closely with other podiatrists, other departments and other healthcare professionals to reduce to a minimum the number of amputations. Due to the vastness of this service, the staff members in this area are being increased.

Podogeriatrics. This is one of the strongest teams. Services are offered in all government homes and residences, in a number of private elderly people’s homes (where there is a PPP arrangement) and in most day centres.

Collaboration with local councils. To date this service is in its initial phase. An agreement has been reached with two local councils (Kalkara and San Ġwann). Once a month podiatrist attend their offices/clinics and offer a service to their respective communities.

Podiatrists aim to give a timely, cost-effective and best possible service to all. Clients who need such a service can either self-refer or access the services through a referral from another healthcare professional. All clients need to do is visit their respective health centre where they are given an appointment. After the initial examination the clients are directed to the most appropriate clinic, according to their needs.

This article has been supplied by the Primary Health Care Department which offers services in the health centres, district clinics and the community.