CURRICULUM VITAE DOUGLAS K. BLACKLIDGE, DPM

Transcription

1 CURRICULUM VITAE DOUGLAS K. BLACKLIDGE, DPM HOME ADDRESS: WORK ADDRESS: 3072 West 250 South Kokomo, IN home mobile Web Sites: American Health Network Foot and Ankle American Health Network Specialty Center American Health Network--Lafayette 2330 S. Dixon Rd Landmark Dr. Ste. A Kokomo, IN Lafayette, IN (fax) (fax) PERSONAL DATA: Birth: 1965, Kokomo, IN Married: Victoria (Benckenstein), 1998 Children: Makenna G., 2001 Macie V., 2003 EDUCATION Bachelor of Science in Biological Sciences Purdue University West Lafayette, IN Doctor of Podiatric Medicine Summa Cum Laude Salutatorian Dr. William M. Scholl College of Podiatric Medicine (S.C.P.M.) Chicago, IL TRAINING 07/92-06/95 Resident in Foot and Ankle Surgery (Three Year Surgical Program) Detroit Medical Center/Wayne State University Hutzel Hospital Affiliate of Wayne State University School of Medicine Training Institutions: Hutzel Hospital, Harper Hospital, Detroit Receiving Hospital, Grace Hospital Wayne State University Health Center 06/94-07/95 Chief Administrative Resident, Podiatric Surgery Detroit Medical Center/Wayne State University Hutzel Hospital 05/95-06/95 Fellowship in Trauma and Reconstructive Surgery (AO Techniques) St. Vincent and Elisabeth Hospital Mainz, Germany Douglas K. Blacklidge, DPM, Curriculum Vitae page 2 SPECIALTY TRAINING 01/93 AO/ASIF Podiatric Course in Internal Fixation Baltimore, MD 12/93 Microneurovascular Surgical Techniques Course, M.O.E.T. Institute San Francisco, CA 11/94 Diabetic Foot Management Course and Rotation, Harvard Medical School Boston, MA 01/95 Baja Project for Crippled Children Mini-Residency/Surgical Session Mexicali, Mexico

2 03/95 Ilizarov Course, ACFAS Scientific Seminar Miami, FL 03/00 MBA Subtalar Joint Arthroerises Workshop Chicago, IL 03/00 External Fixation Workshop Chicago, IL 03/00 Tibial/Intramedullary Nail Workshop Chicago, IL 03/03 Advanced Techniques External Fixation/IM nail, Orthopedic Learning Center, Chicago, IL 10/03 Foot and Ankle Applications of the Ilizarov Method, ACFAS Memphis, TN 05/04 Certified Administrator, PSSD Neurosensory and Motor Testing, -- 07/04 Fellowship, Institute for Peripheral Nerve Surgery, John s Hopkins Medical Center-Baltimore, MD 08/04 Certified in Extracorporeal Shockwave Therapy by United Shockwave Therapies 03/05 Charcot Foot with External Fixation, ACFAS New Orleans, LA 07/05 Ilizarov/Taylor Spatial Frame Course/Workshop, Smith and Nephews 07/05 Ilizarov/Taylor Spatial Frame Course/Workshop, Smith and Nephews New York, NY 03/09 Total Ankle Joint Replacement Course/Workshop, Tornier 09/09 Total Ankle Joint Replacement Course/Workshop, Wright Medical Ft. Wayne, IN 04/11 Total Ankle Joint Replacement Course/Workshop, SBI/STAR Indianapolie, IN 09/11 Circular External Fixation and Lower Limb Deformity Correction/Orthofix Chicago, IL HOSPITAL OR OTHER PROFESSIONAL APPOINTMENTS 06/94-06/95 Clinician/Fellow, Wayne State University/Affiliated Internists, Diabetes Center Diabetic Foot Clinic Wayne State University Health Center, Detroit, MI 07/95-07/97 Associate, Podiatry Associates/Foot and Ankle Institute, 5471 Georgetown Rd. Suite C, /01 IU Health/Methodist Hospital of Indiana, Allied Health Practitioner, Podiatric Surgical Privileges 1997-present Partner, American Health Network of Indiana, LLC Founding Partner, American Health Network Foot and Ankle 1997-present St. Vincent Health/St. Joseph Hospital, 1907 W. Sycamore Rd. Kokomo, IN Allied Health Care Provider, Podiatric Surgical Privileges Riverview Hospital, 395 Westfield Rd. Noblesville, IN present Active Medical Staff, Podiatric Surgical Privileges 1997-present Howard Regional Health System, 3500 S. LaFountain St. Kokomo, IN Allied Staff Podiatric Surgical Privileges 2001-present Indiana Surgery Center Howard Regional Health System 3503 S. Reed Rd. Kokomo, IN Active Medical Staff, Podiatric Surgical Privileges 2006-present Sycamore Springs Surgery Center, 4715 Statesman Dr. Ste A Medical Staff Podiatric Surgical Privileges 2008-present IU Health-- Arnett Hospital, 5165 McCarty Ln., Lafayette, IN Medical Staff Podiatric Surgical Privileges TEACHING/INSTRUCTING POSITIONS.2004Instructor, Podiatric Surgical Residency, Winona Hospital, 11/02-12/02 Instructor, Austrian Trauma Surgeon Rotation in Foot and Ankle Surgery 2004-present Instructor, American Health Network Foot and Ankle Reconstructive Surgery Fellowship Douglas K. Blacklidge, DPM, Curriculum Vitae page 3 PROFESSIONAL SOCIETIES American Podiatric Medical Association (APMA) Indiana Podiatric Medical Association (IPMA) Fellow, American College of Foot and Ankle Surgeons (ACFAS) Diplomat, American Board of Podiatric Surgery (ABPS) LICENSURE AND CERTIFICATION 07/90, 03/91 Parts 1 and 2 Podiatric Medical National Board Exams

3 12/91, 12/94 Podiatric Medical Licensing Examination of States (PMLexis) 07/92-00/97 License # Board of Podiatric Medicine and Surgery, Michigan 03/95 License # Board of Podiatric Medicine, Indiana 06/95 DEA Registration #BB /95 Board Qualified, ABPS 08/98 Certified in Foot Surgery, ABPS 08/98 Certified in Reconstructive Rearfoot/Ankle Surgery, ABPS 02/07 Recertified Foot Surgery, ABPS 02/07 Recertified Reconstructive Rearfoot/Ankle Surgery, ABPS 11/12 BLS and ACLS, Community Howard Regional Health, Kokomo, IN COMMITTEES 08/89-05/91 Member, Student Advisory Board, S.C.P.M. 08/89-04/90 Teaching Assistant, Department of Anatomical Sciences, S.C.P.M. 01/92-05/92 Member, Clinical Advisory Committee, S.C.P.M. 07/95-07/97 Member, Methodist Hospital Wound Care Quality Review Committee 11/00-present Member, Board of Directors, Howard Community Surgery Center, LLC 01/ Representative, Physician Management Council, American Health Network 04/10-present Member, Surgical Standards, IU Health Arnett 03/12 Reviewer, ACFAS Annual Scientific Meeting Poster Exhibit, San Antonio, TX 02/12-present Total Ankle Replacement Committee Member, Riverview Hospital, Noblesville, IN CONSULTING 05/11-present Managing Partner, Indiana Foot and Ankle Consultants, LLC PATENTS 12/11 Provisional Patent metatarsal fixation device HONORS AND AWARDS 1986, 1987 Distinguished Student, Purdue University 1987 Vice President/Treasurer Phi Gamma Delta Fraternity, Purdue University Durlacher National Podiatry Honor Society S.C.P.M. Half-Tuition Scholarship Dr. Walter and Beryl Swanson Half-Tuition Scholarship Podiatry Insurance Company of America Scholarship 05/92 Outstanding Student of Surgery--Dow Corning Wright Award 05/92 Award for Proficiency in Scholarship (Salutatorian), S.C.P.M. 05/92 Graduated with Honors, Summa Cum Laude, S.C.P.M. 02/94 Second Prize, Institutional Poster Exhibit for ACFAS Scientific Seminar Douglas K. Blacklidge, DPM, Curriculum Vitae page 4 PRESENTATIONS (cont.) Fifth Metatarsal Fractures and Fixation 10/92 Hutzel Hospital Seminar, Internal Fixation: Techniques in the Foot Detroit, MI Neglected Achilles Tendon Rupture Repair: Procedure and Functional Results 09/93 Hutzel Hospital Seminar, Multidisciplinary Approach to Foot and Ankle Pathology 10/93 Michigan Podiatric Medical Association Scientific Seminar Boyne Highlands Resort, Harbor Springs, MI Tibialis Anterior Transfer Info Talus for Control of Severe Planus Pediatric Foot 09/94 Michigan Podiatric Medical Association Scientific Seminar Lansing Convention Center, Lansing, MI

4 Principals of Internal Fixation Cannulated Screws Use in Foot and Ankle Surgery 10/94 Hutzel Hospital Seminar, Foot and Ankle Surgical Techniques Updates, Detroit, MI The Foot in Diabetes.95Diabetes Connection (Monthly Lecture Series), Harper Hospital, Detroit, MI 11/95, 08/96 Outpatient Diabetes Series, Hendricks Community Hospital, Danville, IN 05/96 Skin Care Task Force, Methodist Hospital, Acute Exertinal Compartment Syndrome of Medial Foot 03/96 Sheraton New Orleans, New Orleans, LA Arthrodesis of 1 st Metatarsocuneiform Joint 09/96 Hutzel Hospital Seminar, Techniques in Foot and Ankle Surgery Detroit, MI 10/97 Indiana Podiatric Medical Association Doctors Program Tarsometatarsal Arthrodesis 09/96 Hutzel Hospital Seminar, Techniques in Foot and Ankle Surgery Detroit, MI Posterior Heel Pain Achilles Insertional Calcific Tendonitis 10/97 Indiana Podiatric Medical Association Doctors Program Arthrodesis Procedures of the Foot and Ankle 02/01 Indiana Podiatric Medical Association Didactic Lectures Pes Valgo Planus Flexible and Rigid 04/01-08 Midwest Podiatry Conference Surgical Board Review Course Chicago, IL Arthrodesis Techniques First Metatarsophalangeal Joint and First Metatarsocuneiform Joint 09/01 Indiana Podiatric Medical Association Doctors Program Common Surgical Procedure of the Rearfoot and Midfoot 03/02 Midwest Podiatry Conference Surgical Board Review Course Chicago, IL Rearfoot Panel Member 09/06, 09/07 Indiana Podiatric Medical Association Doctors Program Midfoot Denervation by Deep Peroneal Neurectomy Challenging Nerve Cases 11/12 Association of Extremity Nerve Surgeons Annual Meeting Scottsdale, AZ Douglas K. Blacklidge, DPM, Curriculum Vitae page 5 EXHIBITS 02/94 Use of Info Talus Tendon Transfer for Control of the Severe Planus Pediatric Foot Miami Beach, FL 03/96 The Osteomed M3-X Fixation System: A New Bone Screw with Applications in Foot Surgery New Orleans, LA 03/08 Restoration of Functional Length in the Revision of Failed 1 st Metatarsalphalangeal Joint Prosthesis Utilizing Calcaneal Autograft and Plate Fixation Long Beach, CA 03/09 Deep Peroneal Neurectomy for Dorsal Midfoot Pain

5 Washington, D.C. SYMPOSIA 10/92 Internal Fixation Workshop: Techniques in the Foot Hutzel Hospital Detroit, MI Co-coordination, Faculty Speaker/Instructor 09/93 Multidisciplinary Approach to Foot and Ankle Pathology Hutzel Hospital Detroit, MI Co-coordinator, Faculty Speaker 10/94 Foot and Ankle Clinical Pathology Conference of Indiana Foot and Ankle Institute Coordinator 02/99 Internal Fixation Workshop/Cannulated Screws Indiana Podiatric Medical Association Instructor/Speaker 03/03-03/05 Surgical Board Review Course Midwest Podiatry Conference Chicago, IL Co-director, Faculty Speaker 03/03-03/09 Surgical Board Review Course Midwest Podiatry Conference Chicago, IL Faculty Speaker 07/04-present Attending Staff American Health Network Foot and Ankle Reconstructive Surgical Fellowship Monthly Clinical Conference 04/12 Podcast Participant American College of Foot and Ankle Surgeons, San Antonio, TX PUBLICATIONS 1. Kissel, C.G., Blacklidge, D.K., Crowley, D.L. Repair of neglected Achilles tendon ruptures: procedure and functional results. J. Foot and Ankle Surg. 33: 46-52, Kissel, C.G., Blacklidge, D.K. Tibialis anterior transfer into talus for control of the severe planus pediatric foot: a preliminary report. J. Foot and Ankle Surg. 34: , Solomon, M.G., Blacklidge, D.K. Brachymetatarsia: a case study and surgical considerations. J.A.P.M.A. 85: , Kissel, C.G., McQuaid, M., Blacklidge, D.K. The Osteomed M3-X fixation system: a new bone screw with applications in foot surgery. J. Foot and Ankle Surg. 34: , Douglas K. Blacklidge, DPM, Curriculum Vitae page 6 PUBLICATIONS (cont.) 5. Blacklidge, D.K., Kurek, J.B., Resto Soto, A.D., Kissel, C.G. Acute exertional compartment syndrome of the medial foot. J. Foot and Ankle Surg. 35: 19-22, Kissel, C.G., Hulst, T.J., Blacklidge, D.K., Raynor, K.J. Nonresection triple arthrodesis: a retrospective analysis. J. Foot and Ankle Surg. 37: , Blacklidge, D.K. How to Perform an Isolated subtalar joint arthrodesis. Podiatry Today 21-6: June Miller, J.M., Blacklidge, D.K., Ferdowsian, V., Collman, D.R. Chevron arthrodesis of the interphalangeal joint for hammertoe correction. J Foot and Ankle Surg. 49: , Blacklidge, D.K., Masadeh, S.B., Lyons, M.C., Miller, J.M. A preliminary review of the use of deep peroneal neurectomy for the treatment of painful midtarsal and tarsometatarsal arthritis. J Foot and Ankle Surg. 2012

6 REFERENCES Available upon request.