What Today’s Foot and Ankle Surgeons Can Learn From Sigvard T. Hansen, Jr., MD

The foot and ankle community, including both orthopedists and podiatric surgeons, lost a great leader late last year. Sigvard T. Hansen, Jr., MD, a great advocate for the podiatric profession and all foot and ankle surgeons, died November 11, 2023, at age 87.^1,2

We believe the younger generations of foot and ankle surgeons should become aware of Dr. Hansen’s legacy as an innovator in the world of foot and ankle surgery. He developed many of the techniques and philosophies we use today.
 
Dr. Newell met Dr. Hansen in the early 1970s, and formed a close relationship with him as he grew his interest in the foot and ankle, which Dr. Newell notes was not common at the time. In his career, Dr. Hansen was heavily involved with trauma, and was known as the “father of modern traumatology” for his work regarding intramedullary fixation and internal fixation. He also pioneered surgical planning with the goal of getting patients moving sooner to avoid complications of polytrauma.^1,2 We also feel he is a “father of modern foot and ankle surgery” due to his numerous publications, including the well-known Functional Reconstruction of the Foot and Ankle.³ Dr. Hansen was an AO Honorary Trustee and Cofounder of AO of North America (AO NA).⁴ He advocated AO fixation principles in the early 1970s when few foot and ankle surgeons routinely used these techniques.
 
In 1971 Dr. Hansen asked Dr. Newell to join him in opening the Foot and Ankle Clinic at Harborview Medical Center, through the Orthopedic Department at the University of Washington. Dr. Newell began encouraging Dr. Hansen to attend national podiatric meetings, which allowed him to get to know even more podiatric colleagues. Dr. Hansen originally entered college to be a mechanical engineer, so he loved and showed a particular interest in biomechanics, applying much of what he learned to his knowledge of surgical foot and ankle procedures.

Initially, however, Dr. Hansen learned a lot from podiatry, as he stated in his 2000 book: “Stanley G. Newell, DPM and I started the foot and ankle clinic at Harborview in 1971… We learned together by combining information from the fields of podiatry and orthopedics, and tried to carefully evaluate patients from both neuromuscular and static biomechanical aspects. This led to my officially starting a fellowship in foot and ankle surgery in 1989.”³

In 1971 Dr. Hansen invited the Seattle podiatric surgical residents to rotate through the Foot and Ankle Clinic at Harborview. He helped open hospitals around the state of Washington to podiatric surgeons. He lectured locally and nationally and opened doors to train in Europe. He wrote letters of recommendation for podiatric surgeons locally and nationally. In 1975 he recommended Dr. Newell to be a part of the Sports Medicine Department at the University of Washington.

As hundreds from around the U.S. and world rotated through the Sigvard T. Hansen, MD International Foot and Ankle Institute, Dr. Hansen spoke favorably about working alongside the podiatric profession. Harborview Foot and Ankle Clinic later became one of the centers for ankle joint replacement in its infancy. What he learned, he passed onto many podiatric and orthopedic foot and ankle surgeons.

Dr. DiDomenico first met Dr. Hansen at an AO course in the early 1990s, recalling that the audience clearly recognized his extensive experience and talents. His depth of knowledge and experience in the foot and ankle was very apparent. It was clear that he had an outstanding career not only as an orthopedic foot and ankle surgeon, but also as an educational leader. Dr. Hansen taught in an open, honest way, without holding back. He never demonstrated any evidence of any discrimination based on the degree of the surgeon, student, resident or attending doctor. His concern focused on teaching the appropriate techniques and helping improve outcomes for all foot and ankle surgeons and their patients. This first encounter marked the beginning of a longstanding professional friendship.
 
Dr. DiDomenico was fortunate to continue his training with AO Trauma Fellowships in Germany and Switzerland. Dr. Hans Zwipp (Germany) and Dr. Kaj Klaue (Switzerland) (both former fellows of Dr. Hansen) connected him to Dr. Hansen again later on. At that time in the 1990s podiatric physicians could not attend the AO Foot and Ankle courses in Davos, Switzerland. With the assistance of Drs. Hansen, Zwipp and Klaue, Dr. DiDomenico did obtain this education and training, which became the basis for his practice, along with what he learned in an AO Trauma Fellowship under the direction of Dr. Hansen at Harborview Medical Center.  Dr. Hansen’s advocacy for patients and surgeons alike was remarkable.
 
Dr. Hansen also did a pediatric neuromuscular fellowship in England. He combined the knowledge of this training (muscle tendon balancing) with the knowledge of his trauma background (osseous) to comprise a truly wonderful way to evaluate and treat (balance) the lower extremity. We learned in part from his teachings that typical lower extremity deformities consist of muscle/tendon imbalances along with osseous deformities and malalignment.

Dr. Hansen had unbelievable skill and natural knack for foot and ankle surgery. He possessed a great 3-dimensional visual-spatial skill. When total ankle implants were in their relative infancy, we recall his ability to insert some these implants free hand and get it right.
 
Dr. Hansen was a transformational leader, researcher, teacher, and surgeon and who had great vision of what foot and ankle surgical education could be. He had a gift of innovative thinking, a visionary spirit, and the tenacious patience required to successfully lead and share the best in his field.
 
Dr. Newell recalls Dr. Hansen sharing one of his lifetime mottos: “Learn all you can and teach all you can.” Thank you, Sigvard T. Hansen Jr., MD.
 
Dr. Newell was the Director of the Podiatric Residency Program at Harborview Medical Center in Seattle from 1973-1975. He was a Team Podiatrist in the Sports Medicine Department at the University of Washington for 31 years, Team Podiatrist for the Seattle Super Sonics for 17 years, and consulted with Seattle Mariners and Seattle Seahawks. He was the podiatrist for the US Olympic Track and Field Team in Shaw Valley, Team Podiatrist for the US Track and Field Olympic Trials in Eugene, Oregon, and would have been the first podiatrist for the Olympic Games in Moscow in 1980. For 37 years he volunteered for what became the Sigvard T. Hansen Jr., MD Foot and Ankle Institute..

Dr. DiDomenico is the Director of Residency Training at East Liverpool City Hospital, the director of training at NOMS Ankle and Foot Care Center Fellowship, and is an Adjunct Professor at Kent State University College of Podiatric Medicine
 
References
1.     American Orthopaedic Foot and Ankle Society. In memoriam: Sigvard T. Hansen, Jr., MD. Published November 15, 2023. Accessed July 8, 2024.
2.     Sigvard Theodore Hansen, Jr., MD 1935-2023. J Bone Joint Surg. 2024;106(6):566.
3.     Hansen ST. Functional Reconstruction of the Foot and Ankle. 2000;Lippincott, Williams & Wilkins.
4.     AO community mourns the death of Prof Sigvard T. Hansen, MD, the father of modern traumatology. Published November 19, 2023. Accessed July 3, 2024.