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Focus on Daniel A. Osei, MD

Daniel A. Osei, MD, is an assistant professor of orthopedic surgery. His areas of specialty include surgery of the hand, wrist and elbow, including treatment of traumatic and sport related injuries, nerve compression syndromes and degenerative or arthritic conditions. He also specializes in microsurgery and soft tissue coverage and reconstruction of upper and lower extremity.

Dr. Osei sees patients at:

 

The Center for Advanced Medicine, Orthopedic Surgery Center, 4921 Parkview Place, Suite A, 6th floor.
Washington University Orthopedics, 14532 S. Outer 40 Drive.

FOR AN APPOINTMENT, PLEASE CALL 314-514-3500


What happened in the course of schooling to influence you to choose your specialty?

As a medical student, it became clear that my interests were drawing me towards a procedural or technical specialty. During my general surgery clinical rotation, I was introduced to an orthopedic resident who invited me into the emergency room to see a knee injury patient. I found that I could relate to both the patient and injury, having been an athlete. Everything clicked and from that day forward, I realized orthopedics had what I was looking for. That resident ended up being one of my closest friends and trusted mentors.

Up to that point, had you considered orthopedics?

Urology, plastic surgery and orthopedics were all on my short list of possible specialties. After the sneak preview in the ER, I discovered that orthopedics had the environment to which I connected most strongly. A unique aspect of orthopedics is the ability to quickly restore function in your patients – something not seen in other areas that deal with more chronic illnesses. In orthopedics it is not uncommon to have patients who go from being completely disabled to having a full recovery. Undoubtedly that contributes strongly to the satisfaction of our patients; being a part of that process can be very rewarding.

What brought you to Washington University?

Once I made the decision to pursue a hand surgery fellowship after my residency, Washington University was top of my list. In my mind, there was no finer training program for a hand surgeon-to-be. It was clear this was a unique place in terms of exposure to different aspects of hand surgery and having mentors who are the best in their field.

This is a very prominent university that allows the pursuit of all aspects of clinical practice, research and teaching. I was extremely lucky to get a fellowship here.

The following year, I jumped at the opportunity to interview for a faculty opening and was fortunate to have been chosen -- Washington University is a great place and I’m happy to be here.

How did you choose to specialize in hand and wrist surgery?

My plan during the three years of residency was to go into sports medicine. I discovered hand surgery during a rotation in my fourth year with one of my mentors. Much like the decision to go into orthopedics as a specialty, I had an epiphany moment at that time.

Even though I loved sports medicine, specializing in hand surgery was an opportunity to treat a wider variety of patients. While there are sports injuries to be found in hand and upper extremity surgery, there are also the challenges of microsurgery, congenital cases, and the chance to perform more open surgeries.

I liked the idea of maintaining a wider variety of orthopedic surgical skills while still being very specialized in a particular body part. Hand surgery seemed to be the perfect subspecialty for me to pursue, and it’s proven to be the right decision.

Which aspect of your practice do you find most interesting?

Hand ailments affect everyone. From the four-week-old child who has a congenital defect to the 90-year-old person who suffers a fracture from a fall. I find the variety interesting and challenging – no two patients are alike.

I also enjoy consulting with other orthopedic surgeons on difficult cases. For example, if a patient’s trauma injury has a post-surgical infection and won’t heal without adequate blood supply or tissue coverage, it requires taking a more in-depth look at the reasons why – the patient’s age, injury location, the patient’s overall health, does he or she smoke? This specialty provides the chance to actively engage with other physicians and take previous experiences into consideration.

What kind of research are you involved in now?

Peripheral neuropathies interest me from a research standpoint -- the most common nerve compression disorders are carpal tunnel and cubital tunnel syndromes. These are very aggravating conditions that affect a great deal of people.

Related to my interest in extremity reconstruction and microsurgery, I am also involved in clinical research that will help push the boundaries and define better and different ways to manage complex extremity wound issues. This may be of help to both the reconstructive surgeon as well as to the surgeon who might consult with the reconstructive surgeons (such as a trauma surgeon, joint surgeon or tumor surgeon).

My research tends to be more clinically based with very clear and quick applicability.

Do you see an increase in carpal tunnel because of computers and overuse in gaming?

There’s a little bit of controversy in terms of contributing factors to nerve compression syndromes such as carpal tunnel. It’s certainly a complaint we commonly hear from the working population of patients, and a person’s occupational or recreational activities can exacerbate symptoms related to carpal tunnel syndrome. It is harder to prove causation, but a patient’s occupation may be a contributing factor in some cases.

What we do know is that there are certain anatomic areas such as the hand, wrist, and elbow that provide a perfect environment for problems of nerve compression. Although it may be related somewhat to a person’s activities, it’s most likely related to genetics and anatomy. For instance, if someone had a fractured elbow, he or she may end up having ulnar nerve symptoms that present as cubital tunnel syndrome because of that change in the anatomy.

Another example of anatomy-related risk factors is women tend to be affected by carpal tunnel syndrome more often than men. Because a woman’s hand is smaller, the nerve travels through a smaller area and therefore is at greater risk of being compressed.

Are there any new developments in your field that you are excited about?

Hand surgery is unique in orthopedics, which tends to be a “gadgets”-related field. Most of the new developments in hand surgery are likely based on a better understanding of anatomy or a better understanding of how best to implement certain treatments – not new technology.

One area that is relatively new for orthopedic hand surgeons is in the application of soft tissue reconstruction. In a big trauma center, problems such as open fractures or chronic infections after large traumatic injuries are common. While consulting with other specialties can be helpful, having someone who is trained in orthopedic surgery and soft tissue repair who can advise and consult with the primary service provides a unique collaborative opportunity. We feel that the teamwork aspect definitely improves the treatment and hopefully the outcomes.

It’s an exciting idea that has developed recently in the last five to ten years. More and more orthopedic hand surgeons are using their skill set which involves surgery of the blood vessels and nerve and background in general orthopedics to expand from what has been an upper extremity-based specialty to soft tissue specialty. That’s definitely a good development in orthopedics, and certainly in hand surgery.

Where are you from?

I grew up in the New York City metro area, about 30 minutes outside of Manhattan. Most of my schooling was on the East coast. My wife is also from New York City, so it was hard to leave family and friends behind when we moved. New York is an amazing city -- you walk everywhere. I do miss that. While the environment is certainly different here, St. Louis has proven to be a great place to live and work – it’s easy to get around and the people are very friendly.

Is there a particular award or achievement that is most gratifying?

I’m still at the beginning of my career, so hopefully there are achievements or awards to come along. In residency I received an award given to the best orthopedic resident. I’m not really one to reveal in individual accolades, but the acknowledgment for doing things the right way, caring for patients, being a good colleague and working hard was certainly meaningful.

Other than that the most meaningful accomplishment was becoming a parent. Without a doubt, I’ve learned more from that experience and gotten more from that experience than anything that I’ve done in medicine. In my mind , there is nothing like a child to remind you about what matters in life.

Is there a piece of advice that has stuck with you?

My dad used to say –“You shouldn’t try to be a successful person, you should try to be someone who seeks value in life”. I always thought that was a funny thing to say. But in a sense it’s true, because if you are the type of person who is just seeking success, oftentimes you’ll fall short because your objective is in the wrong place.

It’s not so much about accolades or awards; it’s making sure you are doing something of value for your patients, family and society. Are you valuable to your patients? Are you truly their advocate? Do you care about them and not simply the diagnosis they are facing? Value as a person is more than just your job. Are you a good example to your family? When you have those types of larger goals, you will find success and stay pointed in the right direction. I’m pretty sure that’s what my dad meant and it’s certainly the way he lives his life; hopefully I can do the same.
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If you weren’t a doctor, what do you think you’d be doing?

I would have loved to been a soccer player, since that’s what I wanted to be since I was young. I actually started college as a chemical engineer major, but deviated from engineering into the medical field because I liked the interaction with people and the applicability of the sciences towards patients.

Engineering teaches you how to think critically and that can be applied to a lot of different areas. That’s the reason you see engineers in so many professional fields – medicine, finance, basic sciences and economics to name a few.

Most orthopedic problems are solved with an engineering mentality. So when all is said and done, I didn’t venture too far away from that.