[Foot surgery in Germany. Historical burden or scientific challenge?]

In Germany foot surgery was established in the late nineteenth century. To correct foot deformities due to paralytic disorders, i.e., poliomyelitis, and congenital deformities, different types of tenotomies and arthrodeses were developed to obtain plantigrade weight-bearing and to avoid external orthosis. A description of surgical techniques during the last century is presented in detail. During those years resection arthroplasties for hallux valgus were common, although some authors recommended osteotomies of the first metatarsal as joint-sparing techniques. Nowadays, further knowledge in etiology, pathology, and biomechanics have effected the therapeutic algorithm in hallux valgus. Nevertheless, discussion about this topic has not come to an end. In 1991 the German Foot and Ankle Society (D.A.F.) was founded. Educational courses to improve surgical skills as well as clinical workshops were successfully established. A marked increase in membership and a broad international acceptance confirm these activities.